Dr Stefan and colleagues designed a randomized controlled trial in order to evaluate postoperative recovery after hand-assisted laparoscopic or open restorative proctocolectomy with ileal pouch anal anastomosis.
Patients were being treated for ulcerative colitis and familial adenomatous polyposis.
The researchers randomized 60 patients in total for hand-assisted laparoscopic (n = 30) or open surgery (n = 30).
The researchers were looking at a primary outcome parameter of postoperative recovery in the 3 months after surgery, measured by quality of life questionnaires (SF-36 and GIQLI).
Secondary parameters were postoperative morphine requirement and surgical parameters, viz. operating time, morbidity, hospital stay, and costs.
The research team found that there was no difference between the 2 procedures in quality of life assessment in the 3 months after surgery.
However, the researchers found that there was a significant decline in quality of life on all scales of the SF-36 and total GIQLI score in the first 2 weeks in both groups (no significant difference between the groups).
|Neither morbidity nor postoperative hospital stay differed between the laparoscopic and open group|
|Annals of Surgery|
Quality of life returned to baseline levels after 4 weeks.
The research team noted that operating times were longer in the laparoscopic group compared with the open group (210 and 133 minutes, respectively).
In addition, the team found that there were no significant differences in morphine requirement.
Neither morbidity nor postoperative hospital stay differed between the laparoscopic and open group (20% versus 17%, in 10 versus 11 days, respectively).
Median overall costs were [Euro sign] 16.728 for the hand-assisted laparoscopic procedure and [Euro sign] 13.406 for the open procedure.
Dr Stefan concluded, "Recovery measured using quality of life questionnaires is comparable for hand-assisted laparoscopic or open restorative proctocolectomy with ileal pouch anal anastomosis."
"The laparoscopic approach is as safe, but more costly than the open procedure."