**6.3 IPAA-mucosectomy vs. anal transactional zone mucosa and handsewn vs. stapled anastomosis**

The IPAA can be made with transanal mucosectomy and handsewn anastomosis or preserving the anal transitional zone mucosa in a small rectal cuff and stapled anastomosis.

Dafni et al. refer that stapled IPAA and younger age at the onset of UC correlated with better functional results, and the HRQOL scores were high [31].

Kirat et al. studied the influence of stapler size used at IPAA on the anastomotic leak, stricture, long-term functional outcomes, and quality of life. They analyzed the stapled IPAA performed between 1983 and 2007: A (stapler size 28–29 mm) (*n* = 1.221) and B (stapler 31–33 mm) (*n* = 899). They did not found a significant difference in rates of leak (4.5% vs. 6.2%, *p* = 0.08) or stricture (1.9% vs. 2.7%, *p* = 0.1) for groups A and B. There was no significant association between the size of the stapler used at IPAA and long-term complications [32].
