Laparoscopic restorative proctocolectomy with ileal pouch anal XXXX : a comparative observational study on long-term functional results.

@entity1 @entity322 @entity190 @entity254 @entity547
PURPOSE: Long-term results after laparoscopic ileal pouch anal @entity254 (IPAA) have not been thoroughly evaluated. Our study prospectively compares short- and long-term outcomes of laparoscopic and open IPAA. METHODS: Between October 2002 and November 2007, 73 laparoscopic and 106 open IPAA @entity1 were enrolled. @entity1 - and disease-specific characteristics and short- and long-term outcomes were prospectively collected. RESULTS: There were no differences in demographics, treatment, indication, duration of surgery, and diversion between groups. Laparoscopic @entity1 had faster return of flatus (p = 0.008), faster assumption of a liquid diet (p < 0.001), and less @entity190 (p = 0.026). While complications were similar, the incidence of incisional @entity547 was lower in the laparoscopic group (p = 0.011). Mean follow-up was 24.8 months. Average number of bowel movements was 6.8 +/- 2.8/day for laparoscopy and 6.3 +/- 1.7 for open (p = 0.058). Overall, 68.4% of @entity1 were fully continent at 1 year, up to 83.7% long term without differences between groups. Other indicators of defecatory function and quality of life remain similar overtime. CONCLUSIONS: Laparoscopic IPAA confers excellent functional results. Most @entity1 are fully continent and have an average of six bowel movements/day. When present, minor @entity322 improves over time. Laparoscopy mirrors the results of open IPAA and is a valuable alternative to open surgery.
