Journal of Gastrointestinal Surgery

, Volume 18, Issue 2, pp 385–390

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

  • Caitlin W. Hicks
  • Richard A. Hodin
  • Lieba Savitt
  • Liliana Bordeianou
2013 SSAT Quick Shot Presentation

DOI: 10.1007/s11605-013-2359-2

Cite this article as:
Hicks, C.W., Hodin, R.A., Savitt, L. et al. J Gastrointest Surg (2014) 18: 385. doi:10.1007/s11605-013-2359-2

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.

Keywords

Ulcerative colitis Intramesorectal proctectomy Total mesorectal excision Complications 

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Caitlin W. Hicks
    • 1
    • 2
  • Richard A. Hodin
    • 1
  • Lieba Savitt
    • 1
  • Liliana Bordeianou
    • 1
  1. 1.Department of SurgeryMassachusetts General HospitalBostonUSA
  2. 2.Department of SurgeryJohns Hopkins HospitalBaltimoreUSA

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