A Single-Center Experience of Transanal Proctectomy With IPAA for IBD

BACKGROUND: Restorative proctocolectomy with IPAA is the standard procedure in ulcerative colitis patients with medical refractory disease or dysplasia and select patients with IBD unclassified or Crohn’s disease. A variety of minimally invasive techniques have become increasingly utilized, including the transanal IPAA. Unfortunately, despite its growing popularity, there is a lack of high-quality data for the transanal approach. OBJECTIVE: The aim of this study was to investigate clinical outcomes, including complication rates, during our initial experience with the transanal approach. DESIGN: The study design was a single-center prospective case series. SETTINGS: The study was conducted at a tertiary referral center. PATIENTS: The study included patients with ulcerative colitis, IBD unclassified, and Crohn’s disease undergoing 2- or 3-stage restorative proctocolectomy with IPAA. INTERVENTIONS: Consecutive patients after November 2016 undergoing restorative proctocolectomy with transanal approach were compared with a historic cohort of patients who underwent an open approach before October 2016. MAIN OUTCOME MEASURES: The primary outcome measure was early and late anastomotic leak rates during our learning curve. Secondary outcomes included postoperative clinical measures. RESULTS: The study group consisted of 100 open and 65 transanal approach patients. Median (interquartile range) estimated blood loss was lower with ...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research