Association of ileocolic pedicle division with postoperative complications after restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis
© 2021. The Author(s)..
BACKGROUND: When performing a restorative proctocolectomy (RPC) with an ileal pouch-anal anastomosis (IPAA), it is common practice to divide the ileocolic artery (ICA) if the patient has a tumor or dysplasia, or in order to gain sufficient length to secure a tension-free anastomosis. However, it is unclear whether there is an association between division of the ICA and the rate of postoperative complications.
METHODS: We retrospectively analysed all patients with ulcerative colitis who underwent RPC and IPAA in our department between January 2010 and December 2016. These were divided in two groups, with regard to the ICA being preserved (PRE group) or divided (DIV group). Complications such as stenosis or leakage of the IPAA, perianal fistulas, abscess formation within the lesser pelvis and pouchitis were analysed and compared between both groups.
RESULTS: We identified 130 patients meeting the study inclusion criteria, 49 patients in the PRE and 81 patients in the DIV group. No statistical significance was observed in IPAA leakages (p = 0.71), anastomotic strictures (p = 0.33), fistulas (p = 0.19) and pouchitis (p = 0.72). Abscess formation frequency was similar in both groups (p > 0.99). Moreover, short-term (p = 0.53) and long-term complications (p = 0.11) were similar in both groups. A higher conversion rate was observed in obese (p = 0.006) and male (p = 0.02) patients. Within the entire study population, fistulas and IPAA leakages were associated with a higher rate of anastomotic strictures (p = 0.008 and p = 0.02 respectively).
CONCLUSION: Our data suggest similar IPAA related complications after either division or preservation of the ICA. Further trials are required in order to examine the trends observed in this study.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
BMC surgery - 21(2021), 1 vom: 18. Dez., Seite 426 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tzatzarakis, Emmanouil [VerfasserIn] |
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| Links: |
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| Themen: |
Anastomotic leak |
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| Anmerkungen: |
Date Completed 21.12.2021 Date Revised 23.12.2021 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12893-021-01428-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM334585929 |
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| 100 | 1 | |a Tzatzarakis, Emmanouil |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of ileocolic pedicle division with postoperative complications after restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis |
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| 500 | |a Date Revised 23.12.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a BACKGROUND: When performing a restorative proctocolectomy (RPC) with an ileal pouch-anal anastomosis (IPAA), it is common practice to divide the ileocolic artery (ICA) if the patient has a tumor or dysplasia, or in order to gain sufficient length to secure a tension-free anastomosis. However, it is unclear whether there is an association between division of the ICA and the rate of postoperative complications | ||
| 520 | |a METHODS: We retrospectively analysed all patients with ulcerative colitis who underwent RPC and IPAA in our department between January 2010 and December 2016. These were divided in two groups, with regard to the ICA being preserved (PRE group) or divided (DIV group). Complications such as stenosis or leakage of the IPAA, perianal fistulas, abscess formation within the lesser pelvis and pouchitis were analysed and compared between both groups | ||
| 520 | |a RESULTS: We identified 130 patients meeting the study inclusion criteria, 49 patients in the PRE and 81 patients in the DIV group. No statistical significance was observed in IPAA leakages (p = 0.71), anastomotic strictures (p = 0.33), fistulas (p = 0.19) and pouchitis (p = 0.72). Abscess formation frequency was similar in both groups (p > 0.99). Moreover, short-term (p = 0.53) and long-term complications (p = 0.11) were similar in both groups. A higher conversion rate was observed in obese (p = 0.006) and male (p = 0.02) patients. Within the entire study population, fistulas and IPAA leakages were associated with a higher rate of anastomotic strictures (p = 0.008 and p = 0.02 respectively) | ||
| 520 | |a CONCLUSION: Our data suggest similar IPAA related complications after either division or preservation of the ICA. Further trials are required in order to examine the trends observed in this study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anastomotic leak | |
| 650 | 4 | |a Ileal pouch-anal anastomosis | |
| 650 | 4 | |a Ileocolic pedicle division | |
| 650 | 4 | |a Inflammatory bowel disease | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Minimal-invasive surgery | |
| 700 | 1 | |a Herrle, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Reindl, Wolfgang |e verfasserin |4 aut | |
| 700 | 1 | |a Altmayer, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Minas, Dominik |e verfasserin |4 aut | |
| 700 | 1 | |a Kienle, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Reissfelder, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Şandra-Petrescu, Flavius |e verfasserin |4 aut | |
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