Comparison of Three Minimally Invasive Surgical Approaches for Restorative Proctocolectomy in Ulcerative Colitis: A...

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Gastroenterology

Background:

• Restorative proctocolectomy (RPC) is the primary surgical option for ulcerative colitis (UC).
• Optimal minimally invasive surgical (MIS) techniques for RPC in UC patients require further definition.
• Comparing laparoscopic surgery (Lap), hand-assisted laparoscopic surgery (HALS), and reduced port surgery combined with taTME (RPS + taTME) is crucial.

Purpose of the Study:

• To compare postoperative complication rates and surgical outcomes of three MIS approaches for RPC in UC patients.
• To evaluate the efficacy and safety of Lap, HALS, and RPS + taTME.
• To provide data for informed surgical technique selection.

Main Methods:

• Retrospective study of 156 patients undergoing two-stage RPC for UC.
• Procedures performed laparoscopically between February 2002 and February 2022.
• Statistical analysis using Fisher's exact test, ANOVA, and logistic regression.

Main Results:

• No significant differences in postoperative complications were observed among Lap (43.3%), HALS (50.0%), and RPS + taTME (36.0%) groups.
• HALS group showed a significantly shorter operative time.
• RPS + taTME group demonstrated significantly lower estimated blood loss.

Conclusions:

• The three MIS approaches for RPC in UC patients exhibit distinct characteristics.
• Postoperative complication incidence is comparable across Lap, HALS, and RPS + taTME techniques.
• These findings assist colorectal surgeons in choosing the most suitable MIS approach for UC management.