Comparative study between open and laparoscopic total proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: a propensity score-matched study

Abstract

Background The purpose of the study was to compare laparoscopic vs open restorative total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA) for ulcerative colitis regarding safety, feasibility, and postoperative outcome. Patients and methods This is a propensity score-matched study of cases that underwent TPC-IPAA for ulcerative colitis from February 2009 to December 2017. The data were collected from a prospectively maintained web-based hospital registry. Cases were distributed TPC-IPAATPC-IPAA into two classes depending on the form of method: group I (open TPC-IPAA) and group II (laparoscopic TPC-IPAA). Results The duration of the operation was significantly longer in the laparoscopic group (P=0.0001). The length of the wound is significantly longer in the open group (P=0.0001). Postoperative pain was significantly less in the laparoscopic group. Patients in the laparoscopic group started oral intake earlier than the open group (P=0.0001). The incidence of overall postoperative morbidity was 39.3% in the laparoscopic group compared with 60.7% in the open group (P=0.11). Functional outcomes and postoperative anorectal manometry were comparable between both the groups. Conclusion Laparoscopic TPC-IPAA was equivalent to open TPC-IPAA in terms of health and viability. Laparoscopic TPC-IPAA showed superior postoperative cosmoses, less postoperative pain, earlier resumed oral intake, but with longer operating time.