Comparative study between open and laparoscopic total proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: a propensity score-matched study | ||||
The Egyptian Journal of Surgery | ||||
Article 25, Volume 39, Issue 4, December 2020 PDF (94.7 K) | ||||
DOI: 10.4103/ejs.ejs_139_20 | ||||
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Authors | ||||
Mohamed El Desoky; Ayman El Nakeeb; Mohamed El Sorogy; Hosam Hamed; Mohamed Attia; Helmy Ezzat; Mohamed El Hemly; Ahmed El-Geidi; Ahmed Moneer | ||||
Abstract | ||||
Background The purpose of the study was to compare laparoscopic vs open restorative total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA) for ulcerative colitis regarding safety, feasibility, and postoperative outcome. Patients and methods This is a propensity score-matched study of cases that underwent TPC-IPAA for ulcerative colitis from February 2009 to December 2017. The data were collected from a prospectively maintained web-based hospital registry. Cases were distributed TPC-IPAATPC-IPAA into two classes depending on the form of method: group I (open TPC-IPAA) and group II (laparoscopic TPC-IPAA). Results The duration of the operation was significantly longer in the laparoscopic group (=0.0001). The length of the wound is significantly longer in the open group (=0.0001). Postoperative pain was significantly less in the laparoscopic group. Patients in the laparoscopic group started oral intake earlier than the open group (=0.0001). The incidence of overall postoperative morbidity was 39.3% in the laparoscopic group compared with 60.7% in the open group (=0.11). Functional outcomes and postoperative anorectal manometry were comparable between both the groups. Conclusion Laparoscopic TPC-IPAA was equivalent to open TPC-IPAA in terms of health and viability. Laparoscopic TPC-IPAA showed superior postoperative cosmoses, less postoperative pain, earlier resumed oral intake, but with longer operating time. | ||||
Keywords | ||||
lanal incontinence; pouchitis; ulcerative colitis | ||||
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