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Comparative Study
. 2025 Jul 21:62:e25017.
doi: 10.1590/S0004-2803.24612025-017. eCollection 2025.

IMMEDIATE AND LATE RESULTS OF ILEOSTOMY CLOSURE IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS UNDERGOING RESTORATIVE PROCTOCOLECTOMY BY OPEN OR LAPAROSCOPIC APPROACHES

Fábio Guilherme Campos  1 , Carlos Augusto Real Martinez  2 , Carlos Frederico Sparapan Marques  3 , Ulysses Ribeiro Junior  4 , Paulo Herman  4
Affiliations
Comparative Study

IMMEDIATE AND LATE RESULTS OF ILEOSTOMY CLOSURE IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS UNDERGOING RESTORATIVE PROCTOCOLECTOMY BY OPEN OR LAPAROSCOPIC APPROACHES

Fábio Guilherme Campos et al. Arq Gastroenterol. .

Abstract
in English, Portuguese

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.

Objetivo:: Este estudo comparou os resultados após fechamento de ileostomia em pacientes com polipose adenomatosa familiar (PAF) submetidos a proctocolectomia restauradora (PCR) laparoscópica (LAP) ou convencional (OPEN) em uma única instituição.

Métodos:: Pacientes operados entre 1997-2013 foram revisados. Dados demográficos (idade, sexo, cirurgia prévia) e resultados cirúrgicos (acesso cirúrgico original, complicações precoces e tardias, complicações e reoperações após fechamento de ileostomia) foram comparados entre os grupos LAP e OPEN.

Resultados:: Foram identificados 84 pacientes (53 mulheres e 31 homens) com idade média de 30,6 anos (11-64). Vinte e um pacientes (25%) e 63 (75%) formaram os grupos OPEN e LAP, respectivamente. Ambos tinham características demográficas similares. Após PCR, houve 27 complicações precoces (31,1%) e 8 tardias (9,5%), sem mortalidade. Embora o índice geral de morbidade seja similar entre LAP e OPEN, as complicações tardias foram menores após LAP (7,9% x 14,2%). Após fechamento de ileostomia, registraram-se complicações em 6 (7,1%) doentes, em que os operados via LAP também desenvolveram menos complicações (4,7% x 14,2%) reoperações (3,1% x 9,5%). A necessidade de manejo cirúrgico dessas complicações foi maior no grupo OPEN (9,5% x 3,1%). Apesar dessas grandes diferenças numéricas, a análise estatística não revelou diferenças significativas devido aos reduzidos números em cada grupo.

Conclusão:: Nas condições do presente estudo, o acesso abdominal utilizado para a proctoclectomia restauradora não parece influenciar decisivamente a evolução após fechamento de ileostomia em alça. No futuro, a análise de um maior número de paciente provavelmente poderá demonstrar um esperado maior número de complicações e reoperações entre aqueles previamente tratados por procedimentos abertos.

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Conflict of interest statement

Declared conflict of interest of all authors: none

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References

    1. Turnbull RB, Weakley FL. Rev Surg. 1996;23:310–314. - PubMed
    1. Law WL, Chu KW, Choi HK. Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excision. Br J Surg. 2002;89:704–708. - PubMed
    1. Campos FG. Current trends regarding protective ileostomy after restorative proctocolectomy. J Coloproctol. 2013;33:1–4.
    1. Gluszek S, Matykiewicz J. Closing A Temporary Stoma - The Procedure Tactics. Pol Przegl Chir. 2022;94:71–76. - PubMed
    1. Elsner AT, Brosi P, Walensi M, Uhlmann M, Egger E, Glaser C, et al. Closure of Temporary Ileostomy 2 Versus 12 Weeks After Rectal Resection for Cancer: A Word of Caution From a Prospective, Randomized Controlled Multicenter Trial. Dis Colon Rectum. 2021;64:1398–1406. - PMC - PubMed

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