Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gastrointest Surg. 2009 Mar;13(3):526-32. doi: 10.1007/s11605-008-0755-9. Epub 2008 Nov 18.

Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis: a comparative observational study on long-term functional results.

Author information

1
Department of Surgery, MC 5095, University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL 60637, USA. afichera@surgery.bsd.uchicago.edu

Abstract

PURPOSE:

Long-term results after laparoscopic ileal pouch anal anastomosis (IPAA) have not been thoroughly evaluated. Our study prospectively compares short- and long-term outcomes of laparoscopic and open IPAA.

METHODS:

Between October 2002 and November 2007, 73 laparoscopic and 106 open IPAA patients were enrolled. Patient- and disease-specific characteristics and short- and long-term outcomes were prospectively collected.

RESULTS:

There were no differences in demographics, treatment, indication, duration of surgery, and diversion between groups. Laparoscopic patients had faster return of flatus (p = 0.008), faster assumption of a liquid diet (p < 0.001), and less blood loss (p = 0.026). While complications were similar, the incidence of incisional hernias was lower in the laparoscopic group (p = 0.011). Mean follow-up was 24.8 months. Average number of bowel movements was 6.8 +/- 2.8/day for laparoscopy and 6.3 +/- 1.7 for open (p = 0.058). Overall, 68.4% of patients were fully continent at 1 year, up to 83.7% long term without differences between groups. Other indicators of defecatory function and quality of life remain similar overtime.

CONCLUSIONS:

Laparoscopic IPAA confers excellent functional results. Most patients are fully continent and have an average of six bowel movements/day. When present, minor incontinence improves over time. Laparoscopy mirrors the results of open IPAA and is a valuable alternative to open surgery.

PMID:
19015927
DOI:
10.1007/s11605-008-0755-9
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Support Center