Outcomes for case-matched laparoscopically assisted versus open restorative proctocolectomy.
BACKGROUND
The aim of this study was to compare safety, early and late outcomes, quality of life and functional results of laparoscopically assisted versus open ileal pouch-anal anastomosis (IPAA).


METHODS
Patients who had laparoscopically assisted IPAA between 1992 and 2007 were identified from a database and retrospectively matched for age, sex, body mass index (BMI) and operation date to patients who had open IPAA at a ratio of 1:2. Intraoperative, postoperative and long-term functional outcomes were compared. Quality of life was determined by the Cleveland Global Quality of Life scale at 1 and 5 years.


RESULTS
A total of 119 patients (59 men, 60 women; mean(s.d) age 35.5(14.2) years, BMI 24.7(5.0) kg/m(2)) had laparoscopically assisted IPAA, with conversion in nine patients (7.6 per cent); these were compared with 238 patients who had open IPAA. The 30-day and long-term results were similar, as well as quality of life at 1 and 5 years, except that patients in the laparoscopic group had shorter median time to stoma action (2 versus 3 days; P = 0.001) and marginally shorter hospital stay. Median operating times were longer in the laparoscopic group (272 versus 163 min; P = 0.040).


CONCLUSIONS
Laparoscopically assisted IPAA had similar outcomes to open IPAA, but with some short-term advantages.
Department of Colorectal Surgery, A30, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
G S
GS
El-Gazzaz
R P
RP
Kiran
F H
FH
Remzi
T L
TL
Hull
D P
DP
Geisler
D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016022:Case-Control Studies; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome