Deng Shirley Xiaoxuan, Brar Mantaj S, Yang Mei Lucy, Park Jane Jungyoon, de Buck van Overstraeten Anthony
Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
J Gastrointest Surg. 2025 Oct;29(10):102189. doi: 10.1016/j.gassur.2025.102189. Epub 2025 Aug 13.
This single-center, comparative cohort study aimed to compare the functional outcomes between patients who have undergone laparoscopic ileal pouch-anal anastomosis (lap-IPAA) and those who have undergone transanal ileal pouch-anal anastomosis (ta-IPAA).
Patients with ulcerative colitis who underwent IPAA at Mount Sinai Hospital between 2012 and 2022 and were at least 6 months after ileostomy reversal were invited to complete a survey. Patients with colorectal cancer, a handsewn anastomosis, anastomotic leak, or pouch failure were excluded. Questionnaires, including the Colorectal Functional Outcome, International Prostate Symptom Score, Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction, and PROMIS Global-10, were submitted to participants to assess pouch function, urinary function, sexual function, and overall quality of life (QOL), respectively. A retrospective chart review was performed for baseline demographics and clinical data. A propensity score model with inverse probability weighting analysis was performed.
A total of 85 patients (median age of 34.7 years; 54.1% male), of whom 59 underwent lap-IPAA and 26 underwent ta-IPAA, participated in the study. There were no significant differences in sex, age, smoking status, primary sclerosing cholangitis diagnosis, and diabetes mellitus between the groups. There were no significant differences in either overall Colorectal Functional Outcome score (difference in score of -3.0 [95% CI, -11.0 to 4.8]; P =.45) or its domains (incontinence, social effect, frequency, stool-related aspects, and need for medication). In addition, urinary function, male sexual function, and overall QOL were comparable between the 2 groups.
The functional outcomes of patients who undergo IPAA are not harmed by transanal access.
本单中心比较队列研究旨在比较接受腹腔镜回肠储袋肛管吻合术（lap-IPAA）的患者与接受经肛门回肠储袋肛管吻合术（ta-IPAA）的患者之间的功能结局。
邀请2012年至2022年期间在西奈山医院接受IPAA且回肠造口还纳术后至少6个月的溃疡性结肠炎患者完成一项调查。排除患有结直肠癌、手工缝合吻合术、吻合口漏或储袋功能衰竭的患者。向参与者发放问卷，包括结直肠功能结局问卷、国际前列腺症状评分、患者报告结局测量信息系统（PROMIS）性功能和满意度问卷以及PROMIS全球-10问卷，分别评估储袋功能、泌尿功能、性功能和总体生活质量（QOL）。对基线人口统计学和临床数据进行回顾性病历审查。进行了倾向评分模型和逆概率加权分析。
共有85例患者（中位年龄34.7岁；54.1%为男性）参与研究，其中59例接受lap-IPAA，26例接受ta-IPAA。两组之间在性别、年龄、吸烟状况、原发性硬化性胆管炎诊断和糖尿病方面无显著差异。总体结直肠功能结局评分（评分差异为-3.0[95%CI，-11.0至4.8]；P = 0.45）及其各领域（失禁、社会影响、频率、粪便相关方面和用药需求）均无显著差异。此外，两组之间的泌尿功能、男性性功能和总体QOL相当。
经肛门入路不会损害接受IPAA患者的功能结局。
