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- Title
Postoperative complications, bowel function, and prognosis in restorative proctocolectomy for ulcerative colitis—a single-center observational study of 320 patients.
- Authors
Kuwabara, Hiroshi; Kimura, Hideaki; Kunisaki, Reiko; Tatsumi, Kenji; Koganei, Kazutaka; Sugita, Akira; Katsumata, Kenji; Tsuchida, Akihiko; Endo, Itaru
- Abstract
Purpose: To determine the selection criteria, postoperative complications, bowel function, and prognosis of stapled ileal pouch-anal anastomosis (IPAA) and hand-sewn IPAA for ulcerative colitis (UC). Methods: We defined our surgical indications and strategy, and compared the postoperative complications, bowel function, and prognoses between patients who underwent stapled and hand-sewn IPAA for UC at the Yokohama City University Medical Center between 2004 and 2017. Results: Among 320 patients enrolled, 298 patients underwent stapled IPAA while 22 underwent hand-sewn IPAA. There was no significant difference in the postoperative complications between the two groups. Regarding postoperative bowel function, stapled IPAA caused significantly less soiling (stapled vs hand-sewn: 9.1% vs 41.0%, odds ratio (OR) = 0.14, p < 0.0002), spotting (stapled vs hand-sewn: 23.2% vs 63.6%, OR = 0.17, p < 0.0001), and difficulty in distinguishing feces from flatus (stapled vs hand-sewn: 39.9% vs 63.6%, OR = 0.36, p < 0.026). No postoperative neoplasia was observed at the final follow-up in all patients. Conclusion: In this study, there was no clear difference in the postoperative complications between stapled and hand-sewn IPAA, but stapled IPAA resulted in better postoperative bowel function. Postoperative oncogenesis from the residual mucosa is rare. However, future cancer risk remains; thus, careful follow-up is required.
- Subjects
RESTORATIVE proctocolectomy; SURGICAL complications; ULCERATIVE colitis; SURGICAL indications; ACADEMIC medical centers; PROGNOSIS
- Publication
International Journal of Colorectal Disease, 2022, Vol 37, Issue 3, p563
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-021-04059-6