Robotic versus laparoscopic ileal pouch-anal anastomosis (IPAA): a systematic review and meta-analysis

Flynn, Julie; Larach, José Tomás; Kong, Joseph; Warrier, Satish; Heriot, Alexander G.

doi:10.1007/s00384-021-03868-z

Cited by 50 publications

(47 citation statements)

References 32 publications

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“…Our results show that the year of publication did not affect pouch failure rates. This is despite several advancements to the procedure in recent years such as the advent different pouch designs and the introduction of the laparoscopic and robotic approaches [ 38 , 39 ]. Although not specifically investigated in our study, there is evidence to suggest that these advancements have not only led to faster recovery times and progression to restoration of intestinal continuity, but have also led to better functional outcomes over time which have been reported to have a positive impact on patients’ quality of life [ 3 , 38 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of ‘pouch failure’ of the ileoanal pouch in ulcerative colitis: a systematic review and meta-analysis

Alsafi

Snell

Segal

2021

Int J Colorectal Dis

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Background and aims The ileoanal pouch (IPAA) provides patients with ulcerative colitis (UC) that have not responded to medical therapy an option to retain bowel continuity and defecate without the need for a long-term stoma. Despite good functional outcomes, some pouches fail, requiring permanent diversion, pouchectomy, or a redo pouch. The incidence of pouch failure ranges between 2 and 15% in the literature. We conducted a systematic review and meta-analysis aiming to define the prevalence of pouch failure in patients with UC who have undergone IPAA using population-based studies. Methods We searched Embase, Embase classic and PubMed from 1978 to 31st of May 2021 to identify cross-sectional studies that reported the prevalence of pouch failure in adults (≥ 18 years of age) who underwent IPAA for UC. Results Twenty-six studies comprising 23,389 patients were analysed. With < 5 years of follow-up, the prevalence of pouch failure was 5% (95%CI 3–10%). With ≥ 5 but < 10 years of follow-up, the prevalence was 5% (95%CI 4–7%). This increased to 9% (95%CI 7–16%) with ≥ 10 years of follow-up. The overall prevalence of pouch failure was 6% (95%CI 5–8%). Conclusions The overall prevalence of pouch failure in patients over the age of 18 who have undergone restorative proctocolectomy in UC is 6%. These data are important for counselling patients considering this operation. Importantly, for those patients with UC being considered for a pouch, their disease course has often resulted in both physical and psychological morbidity and hence providing accurate expectations for these patients is vital.

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Section: Discussionmentioning

confidence: 99%

Prevalence of ‘pouch failure’ of the ileoanal pouch in ulcerative colitis: a systematic review and meta-analysis

Alsafi

Snell

Segal

2021

Int J Colorectal Dis

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“…The reported incidence and profile of early postoperative complications after an open and laparoscopic IPAA have been well documented and approaches ~ 30%–40% even in experienced and high-volume centers [ 4 , 17 , 18 ]. The data regarding outcomes after robotic IPAA are mainly limited to institutional case series with even fewer studies comparing the different approaches [ 12 ]. The cumulative rate for overall complications in comparative studies for laparoscopic and robotic IPAA has been reported to be 34% and 44%, respectively [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…As a result, IPAA began being performed using the robotic platform because the technology was considered to overcome some of the limitations of laparoscopy and had a shorter learning curve, while potentially preserving the benefits of minimally invasive surgery [ [6] , [7] , [8] ]. Although initial reports and institutional studies found this approach to be safe and feasible [ [9] , [10] , [11] ], comparative studies were unable to detect a substantial advantage of robotic surgery and observed comparable rates of overall complications, anastomotic leaks, and return to operating room been between open, laparoscopic, and robotic approaches [ 12 ]. However, all of these studies were institutional series with small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Equivalency of short-term perioperative outcomes after open, laparoscopic, and robotic ileal pouch anal anastomosis. Does procedure complexity override operative approach?

Opoku

Hart

Thompson

et al. 2022

Surgery Open Science

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“…Recently, robot-assisted surgery has been introduced for total colorectal resection [ 12 , 13 ]. The safety of robot-assisted surgery for total colorectal resection is not inferior to that of laparotomy or laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Proctocolectomy With Transanal Total Mesorectal Excision for Ulcerative Colitis

Ashitomi¹,

Oshio²,

Yano³

et al. 2021

Cureus

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Transanal total mesorectal excision (TaTME) refers to endoscopic retrograde total mesorectal excision and is becoming increasingly popular worldwide. TaTME improves surgical manipulation and minimizes the risk of local recurrence of rectal cancer by ensuring circumferential resection margins. TaTME is mainly indicated for patients in whom transabdominal approaches are expected to be technically challenging. We extended the indications for TaTME to include surgery for ulcerative colitis lesions that might be cancerous in the rectum. Here, we report a case of proctocolectomy with TaTME for ulcerative colitis. A 38-year-old woman who was receiving treatment for ulcerative colitis underwent a biopsy for random samples from the transverse colon to the rectum. Histopathological findings revealed noninvasive dysplasia with p53 overexpression, suggestive of cancer. We extended the indication of TaTME to surgery for ulcerative colitis. We formed two surgical teams and performed laparoscopic proctocolectomy with TaTME simultaneously. This simultaneous operation reduced the duration of the procedures in the present case. The patient was discharged without any complications and underwent loop ileostomy closure four months postoperatively. The patient recovered without significant loss of the anal sphincter function and is doing well four months after the second surgery. We propose laparoscopic proctocolectomy with TaTME to be conducted simultaneously by two teams as a safe and effective technique that is associated with a shorter operation time than that reported previously. Additionally, TaTME was useful in confirming the appropriate dissection layer as well as in surgical manipulation. Hence, TaTME could serve as a useful therapeutic option for ulcerative colitis surgery.

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Robotic versus laparoscopic ileal pouch-anal anastomosis (IPAA): a systematic review and meta-analysis

Cited by 50 publications

References 32 publications

Prevalence of ‘pouch failure’ of the ileoanal pouch in ulcerative colitis: a systematic review and meta-analysis

Prevalence of ‘pouch failure’ of the ileoanal pouch in ulcerative colitis: a systematic review and meta-analysis

Equivalency of short-term perioperative outcomes after open, laparoscopic, and robotic ileal pouch anal anastomosis. Does procedure complexity override operative approach?

Laparoscopic Proctocolectomy With Transanal Total Mesorectal Excision for Ulcerative Colitis

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