Systemic Acute-phase Response in Laparoscopic and Open Ileal Pouch Anal Anastomosis in Patients With Ulcerative Colitis: A Case-matched Comparative Study.
OBJECTIVE
The current trial was designed to study and compare the postoperative outcomes and systemic acute responses between patients undergoing laparoscopic-ileal pouch anal anastomosis (LAP-IPAA) and open IPAA for ulcerative colitis.


METHODS
The clinical records of patients who underwent 89 restorative proctocolectomy procedures with IPAA were reviewed. After determining which patients underwent LAP-IPAA versus open IPAA, an equivalent number of controls matched for age and ulcerative colitis severity were selected.


RESULTS
Twenty of 22 patients who underwent laparoscopic surgery met the inclusion criteria. Patients who underwent LAP-IPAA had significantly shorter times to first walking (P=0.021) and food intake (P=0.0003). The LAP-IPAA group had significantly lower interleukin-6 and interleukin-1ra levels soon after surgery (P=0.011 and P=0.0076). The LAP-IPAA group had significantly lower C-reactive protein levels on postoperative day 1 (P=0.0027).


CONCLUSIONS
LAP-IPAA is a less-invasive operative procedure than open IPAA with respect to the postoperative systemic inflammatory response and postoperative recovery.
Departments of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Yoshiki
Y
Okita
Toshimitsu
T
Araki
Junichiro
J
Hiro
Shozo
S
Ide
Hiroki
H
Imaoka
Satoru
S
Kondo
Mikio
M
Kawamura
Hiroyuki
H
Fujikawa
Mikihiro
M
Inoue
Yuji
Y
Toiyama
Masaki
M
Ohi
Koji
K
Tanaka
Yasuhiro
Y
Inoue
Keiichi
K
Uchida
Yasuhiko
Y
Mohri
Masato
M
Kusunoki
D000210:Acute-Phase Reaction; D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016737:Proctocolectomy, Restorative / Q000379:methods*; D016896:Treatment Outcome