Open versus laparoscopic approach to pouch surgery in patients with ulcerative colitis and familial adenomatous polyposis showed no significant differences in mortality and complications, but the laparoscopic approach resulted in better cosmesis.

Resection of the entire colon and creation of an ileal pouch by means of an ileo pouch anal anastomosis (IPAA) is a last resort for many patients with ulcerative colitis and familial adenomatous polyposis. In recent years this operation has increasingly being performed laparoscopically. In this review we compared the open versus laparoscopic IPAA. We found no significant differences in mortality and complications between the two techniques. The laparoscopic IPAA had a longer operative time of on average 90 minutes. No reliable conclusions could be made regarding the benefit of laparoscopic IPAA on the postoperative recovery. Findings suggest that the laparoscopic approach may improve the postoperative recovery, but the importance of these advantages seems limited. The laparoscopic IPAA did result in better cosmesis than the open IPAA, but more studies will be needed to confirm these findings.
The most important limitation of this review is that we only found one randomised controlled trial (RCT) on this subject, and we therefore needed to include non-randomised controlled trials. Another important limitation is that most studies did not report on important long-term outcomes, like quality of life and functional outcome.