Laparoscopic restorative proctocolectomy

Author:

Kienle P1,Z'graggen K1,Schmidt J1,Benner A2,Weitz J1,Büchler M W1

Affiliation:

1. Department of Surgery, University of Heidelberg, Heidelberg, Germany

2. Central Unit Biostatistics, German Cancer Research Centre, Heidelberg, Germany

Abstract

Abstract Background Restorative proctocolectomy is increasingly being performed using minimally invasive surgery. In published series laparoscopically assisted techniques have usually included a suprapubic incision to enable major parts of the operation to be done openly. Methods Fifty consecutive patients with familial adenomatous polyposis or ulcerative colitis underwent laparoscopic restorative proctocolectomy using only a small perumbilical incision of 4 cm or less for vascular dissection and pouch formation; all other steps were performed entirely laparoscopically. Logistic regression was used for statistical analysis. Results In four patients (8 per cent) the operation was converted to an open procedure. The diagnosis of ulcerative colitis was associated with a higher overall rate of complications (P = 0·011), and an increased body mass index (BMI) with a higher rate of major complications (P = 0·050). The occurrence of wound infection was related to the diagnosis of ulcerative colitis (P = 0·049). Conversion resulted in greater blood loss (P = 0·004), but not in a higher complication rate. No patient required a blood transfusion. Patients with an increased BMI and those taking immunosuppressive therapy had a longer hospital stay (P = 0·043). Conclusion Laparoscopic restorative proctocolectomy is technically feasible. Patients with ulcerative colitis and increased BMI have a higher risk of complications. This minimally invasive technique may reduce the need for perioperative blood transfusion.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference31 articles.

1. Laparoscopic restorative proctocolectomy. Case-matched comparative study with open restorative proctocolectomy;Marcello;Dis Colon Rectum,2000

2. Total laparoscopic proctocolectomy and laparoscopy-assisted proctocolectomy for inflammatory bowel disease: operative technique and preliminary report;Thibault;Surg Laparosc Endosc,1995

3. One-stage laparoscopic restorative proctocolectomy: an alternative to the conventional approach?;Ky;Dis Colon Rectum,2002

4. Laparoscopically assisted colectomy and ileoanal pouch procedure with and without protective ileostomy;Kienle;Surg Endosc,2003

5. Laparoscopic resection for diverticular disease;Bruce;Dis Colon Rectum,1996

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