BACKGROUND: The feasibility and safety of single-incision laparoscopic total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) were first reported in 2010. To improve accuracy and efficiency while maintaining the cosmetic advantages of single-incision laparoscopic surgery, we have since modified the technique to include the use of a 5-mm instrument placed through the eventual drain site. The aim of this study is to compare reduced port laparoscopic (RPL) IPAA with conventional laparoscopic IPAA with respect to short-term outcomes to assess safety. METHODS: RPL cases were matched to conventional laparoscopy cases for patient age (±5 years), body mass index, gender, diagnosis, type and number of stages of surgical procedure, American Society of Anesthesiologists (ASA) classification, and year of surgery (±3 years). Groups were compared using χ(2) or Fisher exact tests for categorical and Wilcoxon rank-sum test for quantitative data. RESULTS: Twenty-four RPL patients were case-matched to an equal number of patients who underwent conventional laparoscopic IPAA. Short-term outcomes including postoperative complications, length of hospital stay, and time to first bowel movement were similar between groups. Despite similar diagnosis, previous surgery, and comorbidity, operative blood loss (p < 0.001) and operating time (p = 0.02) were lower for the RPL group. CONCLUSION: RPL IPAA can be safely performed with short-term outcomes comparable to conventional laparoscopy.
BACKGROUND: The feasibility and safety of single-incision laparoscopic total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) were first reported in 2010. To improve accuracy and efficiency while maintaining the cosmetic advantages of single-incision laparoscopic surgery, we have since modified the technique to include the use of a 5-mm instrument placed through the eventual drain site. The aim of this study is to compare reduced port laparoscopic (RPL) IPAA with conventional laparoscopic IPAA with respect to short-term outcomes to assess safety. METHODS: RPL cases were matched to conventional laparoscopy cases for patient age (±5 years), body mass index, gender, diagnosis, type and number of stages of surgical procedure, American Society of Anesthesiologists (ASA) classification, and year of surgery (±3 years). Groups were compared using χ(2) or Fisher exact tests for categorical and Wilcoxon rank-sum test for quantitative data. RESULTS: Twenty-four RPL patients were case-matched to an equal number of patients who underwent conventional laparoscopic IPAA. Short-term outcomes including postoperative complications, length of hospital stay, and time to first bowel movement were similar between groups. Despite similar diagnosis, previous surgery, and comorbidity, operative blood loss (p < 0.001) and operating time (p = 0.02) were lower for the RPL group. CONCLUSION: RPL IPAA can be safely performed with short-term outcomes comparable to conventional laparoscopy.
Authors: Dhruvil P Gandhi; Madhu Ragupathi; Chirag B Patel; Diego I Ramos-Valadez; T Bartley Pickron; Eric M Haas Journal: J Gastrointest Surg Date: 2010-10-05 Impact factor: 3.452
Authors: Diego I Ramos-Valadez; Madhu Ragupathi; Javier Nieto; Chirag B Patel; Steven Miller; T Bartley Pickron; Eric M Haas Journal: Surg Endosc Date: 2011-07-27 Impact factor: 4.584
Authors: Martin Hübner; Michele Diana; Giorgio Zanetti; Marie-Christine Eisenring; Nicolas Demartines; Nicolas Troillet Journal: Arch Surg Date: 2011-07-18
Authors: Fergal J Fleming; Todd D Francone; Michael J Kim; Douglas Gunzler; Susan Messing; John R T Monson Journal: Dis Colon Rectum Date: 2011-02 Impact factor: 4.585