Abstract
BACKGROUND: Restorative proctocolectomy (RPC) is a common surgical indication to manage familial adenomatous polyposis (FAP) patients. OBJECTIVE: We compared outcomes after ileostomy closure in patients undergoing laparoscopic (LAP) or conventional (OPEN) RPC at one single institution. METHODS: Charts from FAP patients (1997-2013) were reviewed. Demographic data (age, sex, previous surgery) and surgical outcomes (original surgical approach, early and late morbidity, complications and reoperations after ileostomy closure) were compared. RESULTS: A total of 84 patients (53 women and 31 men) submitted to ileostomy closure at a mean age of 30.6 years (11-64) were analyzed. Twenty-one (25%) and 63 patients (75%) formed the OPEN and LAP groups, respectively. Demographic features were similar. After pouch construction, 27 early (32.1%) and 8 late (9.5%) complications occurred, with no mortality. Although overall morbidity rates were similar between both approaches, late complications rate were less common in LAP patients (7.9% x 14.2%). After ileostomy closure, complications were registered in 6 (7.1%) patients, and patients previously operated with the LAP approach also presented less complications (4.7% x 14.2%) and reoperations (3.1% x 9.5%). Additionally, the need for surgical management of complications was greater in the OPEN (9.5%) than the LAP group (3.1%). Besides these numbers, analysis didn't reveal statistical differences among both groups. CONCLUSION: In the conditions of the present manuscript, the abdominal approach used for restorative proctocolectomy doesn't seem to decisively influence outcomes after loop ileostomy reversal. In the future, analysis of a greater number of patients may probably demonstrate an expected greater complication and reoperation rates in those previously treated through OPEN procedures. BACKGROUND: • Ileostomy closure is an important part of the surgical treatment of FAP patients undergoing restorative proctocolectomy by any approach. BACKGROUND: • Complication rates after loop ileostomy reversal occurred in 7% of a group of 84 FAP patients. BACKGROUND: • Among those operated with the laparoscopic approach, complications (4.7% x 14.2%) an reoperations (3.15% X .5%) were less common when compared to the group treated with conventional approach. BACKGROUND: • In the future, annalysis of a greater number of patients may probably reveal an statistical difference between these numbers, thus clearly demonstrating this great advantage of minimally invasive procedures in this group of patients.