Introduction: Laparoscopic techniques have been applied to the procedure of restorative proctocolectomy (RPC). The aim of this study was to compare the outcomes of patients after laparoscopic ileal pouch-anal anastomosis (IPAA) with restorative proctocolectomy (RPC) and without previous colectomy [restorative proctectomy (RP)] and to highlight some technical tips.
Method: Data were collected prospectively from all patients who underwent laparoscopic IPAA from July 2006 to December 2007.
Results: Thirty-six patients underwent IPAA either with total proctocolectomy (n = 25) or after previous emergency colectomy (n = 11). Postoperative morbidity occurred in 22% of patients. The overall median operative time was 210 (range 120-325), 240 (170-325) and 180 (120-240) min for RPC and RP respectively (P < 0.05). The median length of stay for all patients was 6 (3-26), 6 (4-26) and 4 (3-13) days for RPC and RP respectively (P < 0.05). There was no correlation between BMI, age, use of immunosuppressive agents and length of stay. The operative procedure was facilitated by the use of specific devices at particular stages of the operation.
Conclusion: Laparoscopic IPAA is not only safe and feasible for the virgin abdomen but also for patients with a previous emergency colectomy through a midline laparotomy incision.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1463-1318.2008.01590.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The fate of the rectum in ulcerative colitis at index surgery and beyond-a contemporary cohort.
Int J Colorectal Dis
January 2025
Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
Purpose: Proctectomy is frequently deferred at index colectomy for ulcerative colitis due to acuity or immunosuppressive treatments. The retained rectum remains symptomatic in over 50% with associated cancer risk. Management options include index or delayed proctectomy with or without restoration of continuity or surveillance.
View Article and Find Full Text PDFEndoscopic management of ileal pouch-anal anastomosis strictures: meta-analysis and systematic literature review.
Ann Gastroenterol
December 2024
Department of Gastroenterology, Center for Advanced Therapeutic Endoscopy at Porter Adventist Hospital (Douglas G. Adler).
Background: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a common surgical procedure for ulcerative colitis and familial adenomatous polyposis. IPAA strictures are a known complication, often requiring surgical intervention. Endoscopic interventions offer a less invasive alternative, but their safety and efficacy remain uncertain.
View Article and Find Full Text PDFSegmental colectomy versus total proctocolectomy for ulcerative colitis: A systematic review and meta-analysis.
Colorectal Dis
January 2025
Cleveland Clinic, Cleveland, Ohio, USA.
Aim: Total proctocolectomy (TPC) is the standard of care for patients with ulcerative colitis (UC) and dysplasia not amenable to endoscopic management. However, the risks of an extensive resection may outweigh the benefits in high-risk surgical patients. Therefore, we performed a systematic review and meta-analysis to assess postoperative outcomes between segmental colectomy (SEG) versus TPC in patients with UC.
View Article and Find Full Text PDFDiet and Microbiota Modulation for Chronic Pouchitis: Evidence, Challenges, and Opportunities.
Nutrients
December 2024
IBD Unit, UOC CEMAD Centro Malattie dell'Apparato Digerente, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Chronic pouchitis occurs in about 50% of patients undergoing a restorative proctocolectomy for ulcerative colitis. This affection represents a significant therapeutic challenge, particularly for symptomatic patients who do not respond to antibiotic treatments and biologic therapies. Several dietary approaches, including low FODMAP diets and the Mediterranean diet, have shown promising results in improving symptoms and disease burden.
View Article and Find Full Text PDFIleal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications.
Cureus
December 2024
Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, IND.
Background Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is often considered the preferred surgical treatment for ulcerative colitis. This study was conducted to investigate the early and late complications of ileal pouch-anal anastomosis in patients with ulcerative colitis, as well as the factors associated with these complications. Methodology All relevant clinical and operative data of patients (n = 101) who underwent IPAA for ulcerative colitis between January 1995 and December 2018 were retrieved from a prospectively maintained database.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!