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01.02.2014 | 2013 SSAT Quick Shot Presentation | Ausgabe 2/2014

Journal of Gastrointestinal Surgery 2/2014

Does Intramesorectal Proctectomy with Rectal Eversion Affect Postoperative Complications Compared to Standard Total Mesorectal Excision in Patients with Ulcerative Colitis?

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 2/2014
Autoren:
Caitlin W. Hicks, Richard A. Hodin, Lieba Savitt, Liliana Bordeianou
Wichtige Hinweise
This data was presented as a quick-shot oral presentation during the Society for Surgery of the Alimentary Tract (SSAT) 54th Annual Meeting in conjunction with Digestive Disease Week at the Orange County Convention Center in Orlando, Florida, May 18–21, 2013.

Abstract

Introduction

Proctectomy for ulcerative colitis (UC) can be performed via intramesorectal proctectomy with concomitant rectal eversion (IMP/RE) or total mesorectal excision (TME). No data exists comparing the outcomes of the two techniques.

Methods

All UC patients undergoing J-pouch surgery at a single institution over 10.5 years were included. Postoperative complications with IMP/RE vs. TME were analyzed using univariable and multivariable statistics.

Results

One hundred nineteen of 201 (59 %) patients underwent IMP/RE. Demographic and disease characteristics were similar between groups. On univariable analysis, IMP/RE had fewer total perioperative complications than TME (p = 0.02), but no differences in postoperative length of stay or readmissions. Multivariable regression accounting for patient age, comorbidities, disease severity, preoperative medications, operative technique, and follow-up time (mean 5.5 ± 0.2 years) suggested that both anastomotic leak rate (OR 0.32; p = 0.04) and overall postoperative complications (2.10 ± 0.17 vs. 2.60 ± 0.20; p = 0.05) were lower in the IMP/RE group.

Conclusions

IMP/RE may be associated with fewer overall postoperative complications compared to TME. However, further studies on functional and long-term outcomes are needed.

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