Given the liquid stool consistency in the small bowel and the lack of a reservoir capacity after colectomy, a simple ileal anastomosis to the anal verge is expected to leave a patient with excess stool frequency and seepage. Seetharamaiah et al. published a large retrospective study assessing outcomes for 112 IAA and 91 IPAA in children. Surgery indications were UC in 168 and FAP in 35 patients. Daytime and night-time stool frequencies were significantly higher with IAA patients 1–24 months after surgery. By 24 months, the mean number of daytime stools was 8.4 ± 3.9 for IAA and 6.2 ± 2.8 for IPAA. A similar trend was noted in a meta-analysis of pediatric studies. Interestingly, by 24 months, 92% of IAA patients and 95% of IPAA patients were fully continent during day and night–time, with the differences not being statistically significant.
Expert Rev Gastroenterol Hepatol. 2013;7(3):215-223. © 2013 Expert Reviews Ltd.