{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:43:12Z","timestamp":1792586592570,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":164,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Laparoscopic\u2010assisted total proctocolectomy and ileal pouch\u2013anal anastomosis (Lap\u2010IPAA) is a standard surgical procedure for patients with ulcerative colitis (UC), but its operative time can be prolonged due to technical complexity and disease\u2010specific factors. This study aimed to identify risk factors associated with prolonged operative time in hand\u2010sewn Lap\u2010IPAA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010center study included 156 patients with UC who underwent hand\u2010sewn Lap\u2010IPAA 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 \u2265\u2009370\u2009min (75th percentile). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 156 patients, 40 (25.6%) were classified into the prolonged operative time group. Male sex (80.0% vs. 51.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and higher BMI (21.7 vs. 18.6\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were significantly more common in the prolonged group. Multivariate analysis confirmed male sex (OR, 5.153; 95% CI, 1.927\u201313.779;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and BMI (OR, 1.323; 95% CI, 1.146\u20131.526;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as independent risk factors. Other variables, including UC severity, albumin, CRP, and preoperative immunosuppressive therapies, were not significantly associated with operative time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Male sex and elevated BMI were independently associated with prolonged operative time in hand\u2010sewn Lap\u2010IPAA for UC. These findings highlight the importance of preoperative planning and support the centralization of complex UC surgeries to experienced centers, particularly for high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70328","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:36:44Z","timestamp":1781483804000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Prolonged Operative Time in Hand\u2010Sewn Laparoscopic\n                    <scp>IPAA<\/scp>\n                    for Ulcerative Colitis"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7599-6330","authenticated-orcid":false,"given":"Ryuichi","family":"Kuwahara","sequence":"first","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoi","family":"Uchino","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Tomoo","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Nagano","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurando","family":"Kusunoki","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Horio","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Lower Gastrointestinal Surgery, Department of Gastroenterological Surgery, Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozo","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Division of Lower Gastrointestinal Surgery, Department of Gastroenterological Surgery, Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Division of Lower Gastrointestinal Surgery, Department of Gastroenterological Surgery, Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ikeuchi","sequence":"additional","affiliation":[{"name":"Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32448-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.150"},{"key":"e_1_2_11_4_1","volume-title":"Annual Report on the Epidemiology of Ulcerative Colitis in Japan","author":"Committee MIS","year":"2022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-019-01603-8"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.01.055"},{"issue":"5","key":"e_1_2_11_7_1","first-page":"360","article-title":"The Natural History of Ulcerative Colitis: Implications for Treatment and Monitoring","volume":"2","author":"Sandborn W. 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W.","year":"2001","journal-title":"Annals of Surgery"},{"issue":"4","key":"e_1_2_11_12_1","first-page":"693","article-title":"Risk Factors for Prolonged Operative Time for Elective Laparoscopic Colorectal Procedures","volume":"212","author":"Dolejs S. C.","year":"2016","journal-title":"American Journal of Surgery"},{"issue":"7","key":"e_1_2_11_13_1","first-page":"2995","article-title":"Risk Factors for Prolonged Operative Time in Laparoscopic Colorectal Surgery: A Retrospective Analysis","volume":"34","author":"Tanaka S.","year":"2020","journal-title":"Surgical Endoscopy"},{"issue":"8","key":"e_1_2_11_14_1","first-page":"918","article-title":"Predictive Factors for Prolonged Operative Time in Laparoscopic Colorectal Surgery: Results From a Multicenter Prospective Study (JLCSG0901)","volume":"46","author":"Yamada A.","year":"2016","journal-title":"Surgery Today"},{"key":"e_1_2_11_15_1","unstructured":"Research Group on Intractable Inflammatory Bowel Diseases MoHL Welfare of J \u201cDiagnostic Criteria for Ulcerative Colitis. Ministry of Health Labour and Welfare of Japan \u201d(2020)."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2021.2012592"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-021-02295-6"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000216762.83407.d2"},{"key":"e_1_2_11_19_1","volume-title":"Guidelines for Endoscopic Surgery for Certified Surgeons, 2023 Edition","year":"2023"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-40624-5"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12626"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-023-02160-x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.48.4.526"},{"issue":"23","key":"e_1_2_11_24_1","first-page":"5842","article-title":"Colorectal Dysplasia and Cancer Surveillance in Ulcerative Colitis","volume":"13","author":"Ghoury Y. A.","year":"2021","journal-title":"Cancers (Basel)"}],"container-title":["Asian Journal of Endoscopic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ases.70328","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:03:35Z","timestamp":1792584215000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ases.70328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ases.70328"],"URL":"https:\/\/doi.org\/10.1111\/ases.70328","archive":["Portico"],"relation":{},"ISSN":["1758-5902","1758-5910"],"issn-type":[{"value":"1758-5902","type":"print"},{"value":"1758-5910","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70328"}}