Laparoscopic Versus Open Restorative Proctocolectomy for Familial Adenomatous Polyposis

dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCAMPOS, Fabio Guilherme
dc.contributor.authorMARTINEZ, Carlos Augusto Real
dc.contributor.authorCAMARGO, Mariane Gouveia Monteiro de
dc.contributor.authorCESCONETTO, Daniele Menezes
dc.contributor.authorNAHAS, Sergio Carlos
dc.contributor.authorCECCONELLO, Ivan
dc.date.accessioned2018-03-06T15:16:26Z
dc.date.available2018-03-06T15:16:26Z
dc.date.issued2018
dc.description.abstractPurpose: 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.
dc.description.indexMEDLINE
dc.identifier.citationJOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, v.28, n.1, p.47-52, 2018
dc.identifier.doi10.1089/lap.2017.0397
dc.identifier.eissn1557-9034
dc.identifier.issn1092-6429
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/25580
dc.language.isoeng
dc.publisherMARY ANN LIEBERT, INC
dc.relation.ispartofJournal of Laparoendoscopic & Advanced Surgical Techniques
dc.rightsrestrictedAccess
dc.rights.holderCopyright MARY ANN LIEBERT, INC
dc.subjectfamilial adenomatous polyposis
dc.subjectileal pouch anal anastomosis
dc.subjectpostoperative complications
dc.subjectrestorative proctocolectomy
dc.subjectlaparoscopy
dc.subject.otherpouch-anal anastomosis
dc.subject.otherulcerative-colitis
dc.subject.otherseptic complications
dc.subject.otherileal
dc.subject.othersurgery
dc.subject.otheroutcomes
dc.subject.otheradhesions
dc.subject.othercolectomy
dc.subject.otherhernia
dc.subject.othertrial
dc.subject.wosSurgery
dc.titleLaparoscopic Versus Open Restorative Proctocolectomy for Familial Adenomatous Polyposis
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalMARTINEZ, Carlos Augusto Real:Univ Estadual Campinas, Colorectal Surg Div, Sao Paulo, Brazil
hcfmusp.citation.scopus15
hcfmusp.contributor.author-fmusphcFABIO GUILHERME CASERTA MARYSSAEL DE CAMPOS
hcfmusp.contributor.author-fmusphcMARIANE GOUVEA MONTEIRO DE CAMARGO
hcfmusp.contributor.author-fmusphcDANIELLE MENEZES CESCONETTO
hcfmusp.contributor.author-fmusphcSERGIO CARLOS NAHAS
hcfmusp.contributor.author-fmusphcIVAN CECCONELLO
hcfmusp.description.beginpage47
hcfmusp.description.endpage52
hcfmusp.description.issue1
hcfmusp.description.volume28
hcfmusp.origemWOS
hcfmusp.origem.pubmed29125801
hcfmusp.origem.scopus2-s2.0-85040650010
hcfmusp.origem.wosWOS:000416463300001
hcfmusp.publisher.cityNEW ROCHELLE
hcfmusp.publisher.countryUSA
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