Systemic acute phase response in laparoscopic and open ileal pouch anal anastomosis for ulcerative colitis patientsOutstanding Poster Award

Background: The advantages of laparoscopy for ulcerative colitis (UC) seemed to be limited. There has been no study which evaluated systemic acute response in patients who underwent laparoscopic-ileal pouch anal anastomosis (LAP-IPAA) for UC. The current trial was designed to compare postoperative outcomes and systemic acute response between LAP-IPAA and open IPAA for UC.Methods: The clinical records of patients who underwent 89 restorative proctocolectomy procedures with IPAA from January 2009 to December 2013 were reviewed. After determining which patients underwent LAP-IPAA versus open IPAA, an equivalent number of controls matched for age and UC severity were selected. The interleukin-6, interleukin-1ra, and CRP serum levels were measured to assess the impact of the two operative techniques on the acute-phase response.Result: Twenty pairs form 22 LAP-IPAA and 67 open IPAA met the inclusion criteria. Patients who underwent LAP-IPAA had significantly shorter times to first walking (P=0.021) and food intake (P=0.0003). The LAP-IPAA group had significantly lower interleukin-6 and interleukin-1ra levels soon after surgery (P=0.011 and P=0.0076). The LAP-IPAA group had significantly lower CRP levels on postoperative day 1 (P=0.0027). Conclusions: LAP-IPAA is a safe and less invasive operative procedure from the viewpoint of postoperative systemic inflammatory response, postoperative recovery and postoperative complications.