Asian journal of endoscopic surgery · 2026
Risk Factors for Prolonged Operative Time in Hand-Sewn Laparoscopic IPAA for Ulcerative Colitis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kuwahara Ryuichi, Uchino Motoi, Tomoo Yusuke, Nagano Kentaro, Kusunoki Kurando, Horio Yuki, Kimura Kei, Kataoka Kozo, Ikeda Masataka, Ikeuchi Hiroki
Аннотация
INTRODUCTION: Laparoscopic-assisted total proctocolectomy and ileal pouch-anal anastomosis (Lap-IPAA) is a standard surgical procedure for patients with ulcerative colitis (UC), but its operative time can be prolonged due to technical complexity and disease-specific factors. This study aimed to identify risk factors associated with prolonged operative time in hand-sewn Lap-IPAA.
METHODS: This retrospective single-center study included 156 patients with UC who underwent hand-sewn Lap-IPAA between January 2018 and June 2024. Patients receiving stapled IPAA or open surgery were excluded. Clinical, laboratory, surgical, and perioperative data were collected from electronic records. Prolonged operative time was defined as ≥ 370 min (75th percentile). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.
RESULTS: Among the 156 patients, 40 (25.6%) were classified into the prolonged operative time group. Male sex (80.0% vs. 51.7%, p = 0.002) and higher BMI (21.7 vs. 18.6 kg/m2, p < 0.001) were significantly more common in the prolonged group. Multivariate analysis confirmed male sex (OR, 5.153; 95% CI, 1.927-13.779; p < 0.001) and BMI (OR, 1.323; 95% CI, 1.146-1.526; p < 0.001) as independent risk factors. Other variables, including UC severity, albumin, CRP, and preoperative immunosuppressive therapies, were not significantly associated with operative time.
CONCLUSION: Male sex and elevated BMI were independently associated with prolonged operative time in hand-sewn Lap-IPAA for UC. These findings highlight the importance of preoperative planning and support the centralization of complex UC surgeries to experienced centers, particularly for high-risk patients.
METHODS: This retrospective single-center study included 156 patients with UC who underwent hand-sewn Lap-IPAA between January 2018 and June 2024. Patients receiving stapled IPAA or open surgery were excluded. Clinical, laboratory, surgical, and perioperative data were collected from electronic records. Prolonged operative time was defined as ≥ 370 min (75th percentile). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.
RESULTS: Among the 156 patients, 40 (25.6%) were classified into the prolonged operative time group. Male sex (80.0% vs. 51.7%, p = 0.002) and higher BMI (21.7 vs. 18.6 kg/m2, p < 0.001) were significantly more common in the prolonged group. Multivariate analysis confirmed male sex (OR, 5.153; 95% CI, 1.927-13.779; p < 0.001) and BMI (OR, 1.323; 95% CI, 1.146-1.526; p < 0.001) as independent risk factors. Other variables, including UC severity, albumin, CRP, and preoperative immunosuppressive therapies, were not significantly associated with operative time.
CONCLUSION: Male sex and elevated BMI were independently associated with prolonged operative time in hand-sewn Lap-IPAA for UC. These findings highlight the importance of preoperative planning and support the centralization of complex UC surgeries to experienced centers, particularly for high-risk patients.