Analysis on risk factors associated with early postoperative complications after laparoscopic total proctocolectomy plus ileal pouch anal anastomosis for ulcerative colitis patients
10.3760/cma.j.cn101480-20190711-00089
- VernacularTitle:溃疡性结肠炎患者腹腔镜全结直肠切除联合回肠储袋肛管吻合术后发生早期并发症的相关因素分析
- Author:
Xujie DAI
1
;
Jianfeng GONG
1
;
Weiming ZHU
1
Author Information
1. 解放军东部战区总医院（原南京军区南京总医院）普通外科，南京 210002
- Publication Type:Journal Article
- Keywords:
Ulcerative colitis;
Ileal pouch anal anastomosis;
Total proctocolectomy;
Postoperative complications;
Early
- From:
Chinese Journal of Inflammatory Bowel Diseases
2020;04(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors associated with early postoperative complications (within 30 days) after laparoscopic total proctocolectomy (TPC) plus ileal pouch anal anastomosis (IPAA) for patients with ulcerative colitis (UC) .Methods:Clinical data of UC patients undergoing laparoscopic TPC+IPAA treatment from January 2014 to June 2018 at the Inflammatory Bowel Disease Treatment Center, General Hospital of Eastern Theater Command were retrospectively collected. The patients were grouped according to whether complications occurred within 30 days after the operation. The occurrence of early postoperative complications and associated risk factors were analyzed by univariate and multivariate methods.Results:A total of 132 patients were enrolled, including 70 males and 62 females with median age of 42 (16 to 72) years old. Sixty cases of postoperative complications were found in 41 (31.1%) patients, including pouch bleeding occurred (9 cases, 6.8%) , pouch-associated leakage and abdominal or pelvic infection (10 cases, 7.6%) , small bowel obstruction (13 cases, 9.8%) , postoperative delayed gastric emptying (15 cases, 11.4%) , and operative incision infection and pulmonary infection (13 cases, 9.8%) . Preoperative albumin level <35.0 g/L ( P=0.012) and preoperative glucocorticoids usage ≥ 20 mg/d >6 weeks ( P=0.030) were independent risk factors of early postoperative complications. Conclusions:Laparoscopic TPC+IPAA is a safe and effective method in the treatment of patients with ulcerative colitis. Whenever possible, preoperative optimization including increasing the level of preoperative albumin and weaning off corticosteroids will be beneficial to reduce the above morbidity. A two-stage surgery does not increase the risk of postoperative complications.
