Abstract
Background
The feasibility and safety of single-incision laparoscopic total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) were first reported in 2010. To improve accuracy and efficiency while maintaining the cosmetic advantages of single-incision laparoscopic surgery, we have since modified the technique to include the use of a 5-mm instrument placed through the eventual drain site. The aim of this study is to compare reduced port laparoscopic (RPL) IPAA with conventional laparoscopic IPAA with respect to short-term outcomes to assess safety.
Methods
RPL cases were matched to conventional laparoscopy cases for patient age (±5 years), body mass index, gender, diagnosis, type and number of stages of surgical procedure, American Society of Anesthesiologists (ASA) classification, and year of surgery (±3 years). Groups were compared using χ 2 or Fisher exact tests for categorical and Wilcoxon rank-sum test for quantitative data.
Results
Twenty-four RPL patients were case-matched to an equal number of patients who underwent conventional laparoscopic IPAA. Short-term outcomes including postoperative complications, length of hospital stay, and time to first bowel movement were similar between groups. Despite similar diagnosis, previous surgery, and comorbidity, operative blood loss (p < 0.001) and operating time (p = 0.02) were lower for the RPL group.
Conclusion
RPL IPAA can be safely performed with short-term outcomes comparable to conventional laparoscopy.
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Disclosures
Drs. Meagan M. Costedio, Erman Aytac, Emre Gorgun, Ravi P. Kiran, and Feza H. Remzi have no conflicts of interest or financial ties to disclose.
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Costedio, M.M., Aytac, E., Gorgun, E. et al. Reduced port versus conventional laparoscopic total proctocolectomy and ileal J pouch-anal anastomosis. Surg Endosc 26, 3495–3499 (2012). https://doi.org/10.1007/s00464-012-2372-7
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DOI: https://doi.org/10.1007/s00464-012-2372-7