Does Intramesorectal Proctectomy with Rectal Eversion Affect Postoperative Complications Compared to Standard Total Mesorectal Excision in Patients with Ulcerative Colitis?

Caitlin W. Hicks, Richard A. Hodin, Lieba Savitt, Liliana Bordeianou

Research output: Contribution to journalArticle

Abstract

Introduction: Proctectomy for ulcerative colitis (UC) can be performed via intramesorectal proctectomy with concomitant rectal eversion (IMP/RE) or total mesorectal excision (TME). No data exists comparing the outcomes of the two techniques. Methods: All UC patients undergoing J-pouch surgery at a single institution over 10.5 years were included. Postoperative complications with IMP/RE vs. TME were analyzed using univariable and multivariable statistics. Results: One hundred nineteen of 201 (59 %) patients underwent IMP/RE. Demographic and disease characteristics were similar between groups. On univariable analysis, IMP/RE had fewer total perioperative complications than TME (p = 0.02), but no differences in postoperative length of stay or readmissions. Multivariable regression accounting for patient age, comorbidities, disease severity, preoperative medications, operative technique, and follow-up time (mean 5.5 ± 0.2 years) suggested that both anastomotic leak rate (OR 0.32; p = 0.04) and overall postoperative complications (2.10 ± 0.17 vs. 2.60 ± 0.20; p = 0.05) were lower in the IMP/RE group. Conclusions: IMP/RE may be associated with fewer overall postoperative complications compared to TME. However, further studies on functional and long-term outcomes are needed.

Original languageEnglish (US)
Pages (from-to)385-390
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • Complications
  • Intramesorectal proctectomy
  • Total mesorectal excision
  • Ulcerative colitis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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