Techniques d’anastomoses iléoanales avec réservoir

Abstract

Complete proctocolectomy with ileoanal pouch anastomosis is the gold standard for the treatment of familial adenomatous polyposis and ulcerative colitis. In Crohn’s disease, this technique may be considered for selected patients free of anal or small bowel lesions. The two main techniques used for ileoanal anastomosis are the manual anastomosis following mucosectomy (Parks’ procedure, the reference technique), and the stapled anastomosis, the most used procedure worldwide. A third technique exists also, consisting in rectal eversion with section on the dentate line (Hautefeuille procedure); this technique avoid conservation of the anal transitional zone in stapled ileoanal anastomosis, and the risk of incomplete mucosectomy associate with Parks’ procedure. Finally, it is possible today to perform this intervention by laparoscopic approach, provided the operating team has the required training.