Transanal Versus Transabdominal Minimally Invasive (Completion) Proctectomy With Ileal Pouch-anal Anastomosis in Ulcerative Colitis

Abstract

Ta-IPAA for UC is a safe procedure, resulting in fewer patients with morbidity, but comparable CCI when morbidity is present. Overall, ta-IPAA led to lower CCI scores.

Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

“…The IPR wishes to acknowledge the four centres of excellence in continental Europe that have voluntarily contributed detailed submission of data about patients having pouch surgery from their high volume institutions. All these institutions have published individual outcomes from their own practice but have recognized the importance of international collaboration to provide realistic information for future patients considering pouch surgery [35][36][37][38][39]. The IPR aspires to continuing support and international collaboration for the benefit of patients.…”

Transanal completion proctectomy with close rectal dissection and ileal pouch‐anal anastomosis for ulcerative colitis

“…A larger multicenter study compared the outcomes of 97 patients who underwent ta-IPAA with 119 patients who underwent laparoscopic transabdominal IPAA. It found that the ta-IPAA group's odds for postoperative morbidity were 0.52 times lower (95% confidence interval: 0.29-0.92, P = 0.026), and the ta-IPAA group also had a lower conversion rate (5.2% vs 23.5%, P < 0.001) (7). Furthermore, the ta-IPAA group had a shorter length of hospital stay and lower probability of ileus, but there was no difference in the rate of anastomotic leakage.…”

“…In an attempt to reduce conversion rates and improve functional and oncological outcomes, a transanal approach to rectal dissection has been developed, allowing better visualization during rectal dissection and anastomosis creation. Additionally, a transanal access offers better pelvic accessibility in patients with UC, resulting in the same technical improvements as in transanal total mesorectal excision (ta-TME) (7)(8)(9).…”

Transanal total mesorectal excision (TaTME) for inflammatory bowel disease (IBD): review of technique and initial experience

“…A recent report by de Buck van Overstraeten demonstrated a comparable complication rate and lesser postoperative morbidity in TaTME with IPAA compared to conventional laparoscopic pouch surgery [7]. Comparing 97 TaTME procedures with 119 trans-abdominal procedures, they reported a significantly lower complication rate and a lower comprehensive complication index (CCI) in the TaTME group.…”