Thomson-Fawcett et al. evaluated biopsies and clinical parameters in 113 patients undergoing the double-stapled technique over a 2-1/2 year period. They report a 13% incidence of symptomatic cuffitis during this short period of followup. Cuffitis did not correlate with the incidence of pouchitis. They propose a diagnostic triad of symptoms (anal discomfort, anal irritation, discharge, and blood per anum), endoscopic evidence of inflammation, and acute inflammation seen at histology. Cuffitis appears to be a real entity and should be considered as a cause of pouch dysfunction after a double-stapled procedure. Fortunately it is usually not a major problem.
Editor’s note (Stillwater-Ponca City OK): Cuffitis should not be a cause of concern if the surgeon who builds the J-pouch does a complete anal mucosectomy instead of using the double-stapled technique.
