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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/29537

Title: Impact of single-incision laparoscopic surgery on postoperative analgesia requirements after total colectomy for ulcerative colitis: a propensity-matched comparison with multiport laparoscopy
Authors: Famiglietti, F.
Wolthuis, A. M.
De Coster, J.
Vanbrabant, Kenneth
D'Hoore, A.
van Overstraeten, A. de Buck
Issue Date: 2019
Publisher: WILEY
Citation: COLORECTAL DISEASE, 21(8), p. 953-960
Abstract: Aim To compare the requirements for postoperative analgesia in patients with ulcerative colitis after single-incision versus multiport laparoscopic total colectomy. Method All patients undergoing single-incision or multiport laparoscopic total colectomy as a first stage in the surgical treatment of ulcerative colitis between 2010 and 2016 at the University Hospital of Leuven were included. The cumulative dose of postoperative patient-controlled analgesia was used as the primary end-point. A Z-transformation was performed combining values for patient-controlled epidural analgesia and patient-controlled intravenous analgesia, resulting in one hybrid outcome variable. The two groups were matched using propensity scores. Subgroup analysis was performed to analyse the impact of extraction site on postoperative pain. Results A total of 81 patients underwent total colectomy for ulcerative colitis (median age 35 years). Thirty patients underwent single-incision laparoscopy, while 51 patients had a multiport approach. The mean normalized patient-controlled analgesia dose was significantly lower in patients undergoing single-incision laparoscopy (-0.33 vs 0.46, P < 0.001). This difference was no longer significant in subgroup analysis for patients with stoma site specimen extraction (P = 0.131). The odds of receiving tramadol postoperatively was 3.66 times lower after single-incision laparoscopy (P = 0.008). The overall morbidity rate was 32.1% (26/81). The mean Comprehensive Complication Index in single-incision and multiport laparoscopy group was 18.33 and 21.39, respectively (P = 0.506). Hospital stay was significantly shorter after single-incision laparoscopic surgery (6.3 days vs 7.6 days, P = 0.032). Conclusion Single-incision total colectomy was associated with lower postoperative analgesia requirements and shorter hospital stay, with comparable morbidity. However, the specimen extraction site played a significant role in postoperative pain control.
Notes: [Famiglietti, F.; Wolthuis, A. M.; D'Hoore, A.; van Overstraeten, A. de Buck] Katholieke Univ Leuven, Univ Hosp Leuven, Dept Abdominal Surg, Leuven, Belgium. [De Coster, J.] Katholieke Univ Leuven, Univ Hosp Leuven, Dept Anesthesiol, Leuven, Belgium. [Vanbrabant, K.] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Bioinformat, Leuven, Belgium. [Vanbrabant, K.] Univ Hasselt, Hasselt, Belgium. [Vanbrabant, K.] Katholieke Univ Leuven, Univ Hosp Leuven, Leuven, Belgium.
URI: http://hdl.handle.net/1942/29537
DOI: 10.1111/codi.14668
ISI #: 000478607100015
ISSN: 1462-8910
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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