PURPOSE: This study compared outcomes after laparoscopic (LAP) or conventional 
(open) total proctocolectomy with outcomes after ileal J-pouch anal anastomosis 
(IPAA) at a single institution.
METHODS: Charts from 133 familial adenomatous polyposis patients (1997-2013) 
were reviewed. Demographic data (age, sex, color, American Society of 
Anesthesiologists [ASA] status, previous surgery, and body mass index) and 
surgical outcomes (length of stay, early and late morbidity, reoperation, and 
mortality rates) were compared among 63 patients undergoing IPAA.
RESULTS: Demographic features were similar among patients (25 open and 38 LAP). 
Conversely, colorectal cancer at diagnosis prevailed in the open group (60% 
versus 31.6%; P = .02). Tumor stages (P = .65) and previous surgery index (20% 
versus 10.5%; P = .46) were similar. Surgical length was longer for LAP (374 
versus 281 minutes, P = .003). Short-term complication rates (28% versus 28.9%), 
hospital stay (10.9 versus 8.9 days), and total long-term reoperations (28% 
versus 21%) were not statistically different. However, major late morbidity (16% 
versus 2.6%; P < .001) and late reoperation rates (16% versus 5.2%; P < .05) 
were greater among open patients. Both groups did not differ regarding pouch 
failure rates (8% versus 5.2%). There was no operative mortality in the present 
series.
CONCLUSIONS: (1) LAP IPAA is a safe procedure associated with a low conversion 
rate, (2) short-term results showed no clear advantages for both approaches, and 
(3) a greater risk of major late complications and late reoperations should be 
expected after open procedures.