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KMID : 0978820070100020094
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2007 Volume.10 No. 2 p.94 ~ p.99
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Laparoscopic Total Colectomy and Total Proctocolectomy
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Bae Sung-Uk
Kim Chang-Nam
Choo Ah-Reum
Park Hye-Won
Choi Young-Jin
Lee Min-Koo
Joe Byung-Sun
Kang Yoon-Jung
Park Joo-Seung
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Abstract
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Purpose: The role of a laparoscopic total colectomy (LTC) and total proctocolectomy (LTPC) have been controversial because of a long operative time, technical difficulty, high conversion rate and high complication rate. The aim of the study was to evaluate short-term clinical outcomes after LTC and LTPC from an evaluation of 13 patients.
Methods: From January 2002 to October 2007, 13 patients (6 males and 7 females) that had undergone LTC and LTPC were chosen for this study. Age, gender, underlying disease, surgical time, complications, mortality, changes in defecation, and length of hospital stay were evaluated.
Results: Among the 13 patients, nine patients underwent LTC and four patients underwent LPTC. The mean patient age was 45 years (age range, 24∼71 years). Five patients underwent surgery for familial adenomatous polyposis (FAP), four patients underwent surgery for colonic inertia, two patients underwent surgery for hereditary nonpolyposis colorectal cancer (HNPCC), one patient underwent surgery for colon cancer with multiple polyps and one patient underwent surgery for diverticulitis. The mean surgical time was 519 minutes (range, 265∼770 minutes). Two complications occurred (15.3%) with no mortality. There were no intra-operative complications or open conversions. The average time to flatus and diet was 2.2 and 5 days, respectively. Patients were discharged at a mean 16.5 post-operative days. At postoperative interviews, nearly all patients were satisfied with the surgery.
Conclusion: We have shown that the LTC and LTPC are feasible and safe to perform. Additionally, we believe that LTC and LTPC have the potential to become an attractive alternative to the conventional open approach, especially for young and female patients.
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KEYWORD
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Laparoscopic surgery, Total colectomy, Total proctocolectomy
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