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Laparoscopic Versus Open Restorative Proctocolectomy for Familial Adenomatous Polyposis.
Campos, Fábio Guilherme; Real Martinez, Carlos Augusto; Monteiro de Camargo, Mariane Gouveia; Cesconetto, Daniele Menezes; Nahas, Sérgio Carlos; Cecconello, Ivan.
Afiliação
  • Campos FG; 1 Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo , São Paulo, Brazil .
  • Real Martinez CA; 2 Colorectal Surgery Division, University of Campinas, São Paulo, Brazil .
  • Monteiro de Camargo MG; 1 Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo , São Paulo, Brazil .
  • Cesconetto DM; 1 Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo , São Paulo, Brazil .
  • Nahas SC; 1 Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo , São Paulo, Brazil .
  • Cecconello I; 1 Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo , São Paulo, Brazil .
J Laparoendosc Adv Surg Tech A ; 28(1): 47-52, 2018 Jan.
Article em En | MEDLINE | ID: mdl-29125801
PURPOSE: This study compared outcomes after laparoscopic (LAP) or conventional (open) total proctocolectomy with outcomes after ileal J-pouch anal anastomosis (IPAA) at a single institution. METHODS: Charts from 133 familial adenomatous polyposis patients (1997-2013) were reviewed. Demographic data (age, sex, color, American Society of Anesthesiologists [ASA] status, previous surgery, and body mass index) and surgical outcomes (length of stay, early and late morbidity, reoperation, and mortality rates) were compared among 63 patients undergoing IPAA. RESULTS: Demographic features were similar among patients (25 open and 38 LAP). Conversely, colorectal cancer at diagnosis prevailed in the open group (60% versus 31.6%; P = .02). Tumor stages (P = .65) and previous surgery index (20% versus 10.5%; P = .46) were similar. Surgical length was longer for LAP (374 versus 281 minutes, P = .003). Short-term complication rates (28% versus 28.9%), hospital stay (10.9 versus 8.9 days), and total long-term reoperations (28% versus 21%) were not statistically different. However, major late morbidity (16% versus 2.6%; P < .001) and late reoperation rates (16% versus 5.2%; P < .05) were greater among open patients. Both groups did not differ regarding pouch failure rates (8% versus 5.2%). There was no operative mortality in the present series. CONCLUSIONS: (1) LAP IPAA is a safe procedure associated with a low conversion rate, (2) short-term results showed no clear advantages for both approaches, and (3) a greater risk of major late complications and late reoperations should be expected after open procedures.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Canal Anal / Proctocolectomia Restauradora / Laparoscopia / Polipose Adenomatosa do Colo / Bolsas Cólicas / Íleo Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Laparoendosc Adv Surg Tech A Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Canal Anal / Proctocolectomia Restauradora / Laparoscopia / Polipose Adenomatosa do Colo / Bolsas Cólicas / Íleo Tipo de estudo: Diagnostic_studies / Etiology_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Laparoendosc Adv Surg Tech A Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos