Modified 2-stage IPAA has similar postoperative complication rates and functional outcomes compared to 3-stage IPAA - 17/04/24
, W. Lin, D. Shojaei, P. Au-Yeung, A. Motamedi, P.T. PhangAbstract |
Introduction |
Reconstructive ileal-pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is often created in 3-stages: colectomy + ileostomy, proctectomy + pouch creation with diverting loop ileostomy, then subsequent ileostomy closure. Modified 2-stage IPAA is without pouch diversion, thus avoiding a third operation. This study compares perioperative complications, quality of life (QOL) and functional outcomes of 3- versus modified 2-stage IPAA.
Methods |
Charts were reviewed for adult UC patients undergoing IPAA between 2010 and 2020. QOL and function were assessed with EQ-5D-3L Quality of Life and Pouch Functional Score questionnaires.
Results |
152 patients were identified. 43 modified 2-stage and 109 3-stage IPAA were similar for anastomotic leak (9.3% vs. 1.8%, p = 0.06), SSI (34.9% vs. 29.7%, p = 0.51) and ileus (32.6% vs. 33%, p = 0.96). Modified 2-stage had less bowel obstruction than 3-stage IPAA (7.0% vs. 30.1%, p = 0.006). 92 patients returned questionnaires with similar QOL and pouch function.
Conclusions |
Perioperative complications, QOL and function are similar for 3-stage IPAA and modified 2-stage IPAA. Modified 2-stage IPAA in select patients is safe and has less postoperative bowel obstruction than 3-stage IPAA.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Compared to 3-stage, modified 2-stage IPAA yields similar rates of anastomotic leak. |
• | Compared to 3-stage, modified 2-stage IPAA yield similar rates of pouch failure. |
• | Compared to 3-stage, modified 2-stage IPAA has lower rates of readmission. |
• | Compared to 3-stage, modified 2-stage IPAA has lower rates of bowel obstruction. |
• | Modified 2-stage IPAA has similar pouch function and QoL compared to 2-stage IPAA. |
Keywords : Ileal pouch-anal anastomosis complications, J-pouch, Proctocolectomy, 3-Stage ileal pouch anal anastomosis, Ulcerative colitis, Ileostomy, Complications
Plan
Vol 231
P. 96-99 - mai 2024 Retour au numéro
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