Michela Mineccia1, Francesca Cravero2, Paolo Massucco2, Luca Portigliotti3, Franco Bertolino4, Marco Daperno5, Alessandro Ferrero2. 1. Department of Chirurgia Generale e Oncologica, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Torino, Italy. Electronic address: mmineccia@mauriziano.it. 2. Department of Chirurgia Generale e Oncologica, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Torino, Italy. 3. Department of Chirurgia Generale, Ospedale Maggiore Della Carità, Corso Mazzini 18, 28100, Novara, Italy. 4. Department of Chirurgia Generale, Ospedale SS Annunziata, Via Ospedali 14, 12038, Savigliano, CN, Italy. 5. Department of Gastroenterologia, Ospedale Mauriziano Umberto I, Largo Turati 62, 10100, Torino, Italy.
Abstract
BACKGROUND: Patients with ulcerative colitis are often young, and proctocolectomy with restorative ileo-pouch anal anastomosis is a crucial act that can improve or worsen the quality of the rest of their lives. The literature is scant on long-term functional outcomes after laparoscopy. The purpose of this study was to investigate results in terms of pouch function after standardized total laparoscopic technique compared with open intervention. MATERIALS AND METHODS: This was a retrospective comparative study. Cases were collected from the prospectively-maintained database of the Unit of General and Oncologic Surgery, XXX, Torino, Italy. Patients treated between May 2005 and May 2015 with three-stage laparoscopic or open proctocolectomy and ileo-pouch anal anastomosis were enrolled. The primary study endpoint was the percentage of well-functioning pouches. Secondary endpoints were postoperative early and late outcomes such as morbidity and pouch survival. RESULTS: Of the 78 patients identified, 48 underwent the open technique and 30 underwent laparoscopy. Median follow-up was 4 years. The overall complication rates were 19% and 13% (p = 0.5), and there were major complications (Clavien-Dindo III-IV) in 14.6% and 13.3% of patients in the open and laparoscopic groups, respectively (p = 0.8). Late complications occurred in 26 patients. Nine (18.8%) and 5 (16.7%) patients had pouchitis (p = 0.8), and 6 (12.5%) and 2 (6.7%) had cuffitis in the open and laparoscopic groups, respectively (p = 0.70). Pouch failure occurred in 2 patients (4.2%) in the open group and 2 (6.7%) in the laparoscopic group. The pouch was observed to be functioning very well in 18 patients (37.5%) in the open group and in 17 patients (56%) in the laparoscopic group (p = 0.09). The study was limited by its retrospective, nonrandomized design. CONCLUSION: Our data demonstrated similar early and late results after total laparoscopic and open proctocolectomy, in particular concerning pouch function.
BACKGROUND:Patients with ulcerative colitis are often young, and proctocolectomy with restorative ileo-pouch anal anastomosis is a crucial act that can improve or worsen the quality of the rest of their lives. The literature is scant on long-term functional outcomes after laparoscopy. The purpose of this study was to investigate results in terms of pouch function after standardized total laparoscopic technique compared with open intervention. MATERIALS AND METHODS: This was a retrospective comparative study. Cases were collected from the prospectively-maintained database of the Unit of General and Oncologic Surgery, XXX, Torino, Italy. Patients treated between May 2005 and May 2015 with three-stage laparoscopic or open proctocolectomy and ileo-pouch anal anastomosis were enrolled. The primary study endpoint was the percentage of well-functioning pouches. Secondary endpoints were postoperative early and late outcomes such as morbidity and pouch survival. RESULTS: Of the 78 patients identified, 48 underwent the open technique and 30 underwent laparoscopy. Median follow-up was 4 years. The overall complication rates were 19% and 13% (p = 0.5), and there were major complications (Clavien-Dindo III-IV) in 14.6% and 13.3% of patients in the open and laparoscopic groups, respectively (p = 0.8). Late complications occurred in 26 patients. Nine (18.8%) and 5 (16.7%) patients had pouchitis (p = 0.8), and 6 (12.5%) and 2 (6.7%) had cuffitis in the open and laparoscopic groups, respectively (p = 0.70). Pouch failure occurred in 2 patients (4.2%) in the open group and 2 (6.7%) in the laparoscopic group. The pouch was observed to be functioning very well in 18 patients (37.5%) in the open group and in 17 patients (56%) in the laparoscopic group (p = 0.09). The study was limited by its retrospective, nonrandomized design. CONCLUSION: Our data demonstrated similar early and late results after total laparoscopic and open proctocolectomy, in particular concerning pouch function.
Authors: Michela Mineccia; Giovanni Maconi; Marco Daperno; Maria Cigognini; Valeria Cherubini; Francesco Colombo; Serena Perotti; Caterina Baldi; Paolo Massucco; Sandro Ardizzone; Alessandro Ferrero; Gianluca M Sampietro Journal: J Clin Med Date: 2022-04-01 Impact factor: 4.241