Laparoscopic-assisted vs. open ileal pouch-anal anastomosis: Functional outcome in a case-matched series

David Larson, Eric Dozois, Karen Piotrowicz, Robert R. Cima, Bruce G. Wolff, Tonia M. Young-Fadok

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

PURPOSE: Functional outcomes in laparoscopic-assisted ileal pouch-anal anastomosis have been incompletely studied. More than one-year follow-up has rarely been reported in these patients. This study was designed to assess operative, functional, and quality of life outcomes in patients with ulcerative colitis or familial adenomatous polyposis a minimum of one year after. METHODS: Thirty-three laparoscopic-assisted ileal pouch-anal anastomosis and 33 open ileal pouch-anal anastomosis patients, with a median of 13 months and minimum of 12 months follow-up, were identified from a prospective, laparoscopic database. Functional outcome was prospectively assessed by using a standardized survey. These cohorts were matched by individual patient for year of surgery, age, gender, body mass index, and indication. RESULTS: Median age was 27 years (open) and 28 years (laparoscopic). There were 27 females and 6 males in each group. All operations occurred between 1999 and 2001. Median body mass index was 22.3 (open) and 21.7 (laparoscopic) groups. There were no significant differences in diagnosis, use of diversion, and anastomotic technique. Postoperative morbidity occurred in 6 percent of the laparoscopic cases and 12 percent of the open cases. Functional outcome after a minimum of one year revealed equivalent median day and median nocturnal number of stools of six to seven and one to two respectively. Consistency of stool, medication usage, and continence were no different between groups. Daytime and nocturnal incontinence was similar. Quality of life in regard to social, home life, family, travel, sports, recreation, and sex life were equivalent. CONCLUSIONS: The function and quality of life outcomes for patients undergoing laparoscopic-assisted ileal pouch-anal anastomosis seem to be equivalent to our open experience. Laparoscopic-assisted ileal pouch-anal anastomosis offers selected patients a safe, feasible, and durable alternative.

Original languageEnglish (US)
Pages (from-to)1845-1850
Number of pages6
JournalDiseases of the Colon and Rectum
Volume48
Issue number10
DOIs
StatePublished - Oct 2005

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Colonic Pouches
Quality of Life
Body Mass Index
Recreation
Adenomatous Polyposis Coli
Ulcerative Colitis
Sports
Databases
Morbidity

Keywords

  • Function
  • Ileal pouch-anal anastomosis
  • Laparoscopy
  • Quality of life
  • Surgery
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Laparoscopic-assisted vs. open ileal pouch-anal anastomosis : Functional outcome in a case-matched series. / Larson, David; Dozois, Eric; Piotrowicz, Karen; Cima, Robert R.; Wolff, Bruce G.; Young-Fadok, Tonia M.

In: Diseases of the Colon and Rectum, Vol. 48, No. 10, 10.2005, p. 1845-1850.

Research output: Contribution to journalArticle

Larson, David ; Dozois, Eric ; Piotrowicz, Karen ; Cima, Robert R. ; Wolff, Bruce G. ; Young-Fadok, Tonia M. / Laparoscopic-assisted vs. open ileal pouch-anal anastomosis : Functional outcome in a case-matched series. In: Diseases of the Colon and Rectum. 2005 ; Vol. 48, No. 10. pp. 1845-1850.
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T1 - Laparoscopic-assisted vs. open ileal pouch-anal anastomosis

T2 - Functional outcome in a case-matched series

AU - Larson, David

AU - Dozois, Eric

AU - Piotrowicz, Karen

AU - Cima, Robert R.

AU - Wolff, Bruce G.

AU - Young-Fadok, Tonia M.

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AB - PURPOSE: Functional outcomes in laparoscopic-assisted ileal pouch-anal anastomosis have been incompletely studied. More than one-year follow-up has rarely been reported in these patients. This study was designed to assess operative, functional, and quality of life outcomes in patients with ulcerative colitis or familial adenomatous polyposis a minimum of one year after. METHODS: Thirty-three laparoscopic-assisted ileal pouch-anal anastomosis and 33 open ileal pouch-anal anastomosis patients, with a median of 13 months and minimum of 12 months follow-up, were identified from a prospective, laparoscopic database. Functional outcome was prospectively assessed by using a standardized survey. These cohorts were matched by individual patient for year of surgery, age, gender, body mass index, and indication. RESULTS: Median age was 27 years (open) and 28 years (laparoscopic). There were 27 females and 6 males in each group. All operations occurred between 1999 and 2001. Median body mass index was 22.3 (open) and 21.7 (laparoscopic) groups. There were no significant differences in diagnosis, use of diversion, and anastomotic technique. Postoperative morbidity occurred in 6 percent of the laparoscopic cases and 12 percent of the open cases. Functional outcome after a minimum of one year revealed equivalent median day and median nocturnal number of stools of six to seven and one to two respectively. Consistency of stool, medication usage, and continence were no different between groups. Daytime and nocturnal incontinence was similar. Quality of life in regard to social, home life, family, travel, sports, recreation, and sex life were equivalent. CONCLUSIONS: The function and quality of life outcomes for patients undergoing laparoscopic-assisted ileal pouch-anal anastomosis seem to be equivalent to our open experience. Laparoscopic-assisted ileal pouch-anal anastomosis offers selected patients a safe, feasible, and durable alternative.

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