Lucas Gerbasi, Rodrigo Pinto, Mariane Camargo, Cintia Kimura, Anna Carolina Dantas, Diego Soares, Fabio Campos, Sergio Nahas, Ivan Cecconelo. HCFMUSP
Introduction: Total proctocolectomy with ileal pouch-anal anastomosis is the best surgical therapeutic option for Familiar Adenomatous Polyposis (FAP) with rectum involvement and Ulcerative Colitis (UC) with no response to clinical treatment. There is still limited data regarding laparoscopic approach.
Objectives: To compare perioperative morbidity of laparoscopic total proctocolectomy with ileal pouch-anal anastomosis between patients with FAP and UC.
Methods: Consecutive patients with UC and FAP who underwent surgical treatment between 2005 and 2016 were retrospectively reviewed from a prospectively maintained database. The primary outcome was 30-day morbidity, recorded using Clavien-Dindo classification system. Major complication was defined as Clavien-Dindo classification ≥ 3. Statistical analysis was made using the software SPSS®.
Results: From a total of 34 patients, 10 had UC and 24 had FAP. Both populations had no difference as related to comorbidities, Mass Index (BMI), preoperative hemoglobin or American Society of Anesthesiology (ASA) classification. Patients with UC were significantly older (39,9 vs. 26,9 years, p=0,002). Overall, 16 (47,1%) patients had no complications, 11 (32,3%) had minor and 7 (20,6%) had major complications. There was no 30-day post-operative mortality. Reoperation was necessary for 5 (14,7%) patients, and anastomotic leakage occurred in 9 (26,5%). Patients with UC had significantly higher anastomotic leakage (50% vs. 16,7%, p=0,45), post-operative blood transfusion (30% vs. 0, p=0,005) and hospital stay (14,7 vs. 8,6 days, p=0,007).
Conclusion: Laparoscopic total proctocolectomy with ileal pouch-anal anastomosis is a high morbidity surgical procedure, especially in UC patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80135
Program Number: P252
Presentation Session: Poster (Non CME)
Presentation Type: Poster
