Restorative proctocolectomy is the "gold standard" in surgical treatment for ulcerative colitis and familial adenomatous polyposis. The two alternative techniques of ileal-pouch-anal anastomosis include handmade and double line stapled suture.The aim of the study was to analyze postoperative complications and functional results of the two types of anastomosis.Material and methods. The study group consisted of 108 patients operated between 1994 and 2005 for ulcerative colitis (n=97) or familial adenomatous polyposis (n=11). Stapled anastomosis was performed in 88 (81.5%) cases and hand-made suture was performed in 20 (18.5%) cases.Results. No significant differences between the two anastomotic techniques were found in terms of postoperative complications and late functional results.Conclusions. The low rate of complications and well-accepted functional outcomes prove that restorative proctocolectomy is a safe surgical procedure that can be offered to patients with ulcerative colitis or familial adenomatous polyposis. Double line stapled suture should be the preferred method of ilealpouch-anal anastomosis, however, the hand-made suture remains its valuable alternative and may be considered in selected cases.