Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPCAMPOS, Fabio GuilhermeMARTINEZ, Carlos Augusto RealCAMARGO, Mariane Gouveia Monteiro deCESCONETTO, Daniele MenezesNAHAS, Sergio CarlosCECCONELLO, Ivan2018-03-062018-03-062018JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, v.28, n.1, p.47-52, 20181092-6429https://observatorio.fm.usp.br/handle/OPI/25580Purpose: 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.engrestrictedAccessfamilial adenomatous polyposisileal pouch anal anastomosispostoperative complicationsrestorative proctocolectomylaparoscopypouch-anal anastomosisulcerative-colitisseptic complicationsilealsurgeryoutcomesadhesionscolectomyherniatrialarticleCopyright MARY ANN LIEBERT, INC10.1089/lap.2017.0397Surgery1557-9034