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KMID : 1035920150180030069
Journal of Minimally Invasive Surgery
2015 Volume.18 No. 3 p.69 ~ p.74
Operative Outcomes of Open versus Laparoscopic Total Proctocolectomy with Ileal Pouch Anal Anastomosis in Ulcerative Colitis
:Nam Soo-min
:Park Eun-Jung/:Cho Min-Soo/:Kang Jeong-hyun/:Hur Hyuk/:Min Byung-Soh/:Baik Seung-Hyuk/:Lee Kang-Young/:Kim Nam-Kyu/:Sohn Seung-Kook
Abstract
Purpose : During the course of disease, nearly 30% of ulcerative colitis patients receive surgical therapy. Total proctocolectomy with ileal pouch anal anastomosis is a standard procedure. However, the effectiveness of laparoscopic surgery in ulcerative colitis has not yet been proven. We aimed to evaluate the clinical course of both laparoscopic and open surgeries of a total proctocolectomy with ileal pouch anal anastomosis.

Methods : We reviewed charts of 34 patients who underwent a total proctocolectomy with ileal pouch anal anastomosis between April 2005 and April 2014. The laparoscopic group (n=21) and the open group (n=13) were compared retrospectively in accordance with patients¡¯ demographics, clinical features, operative data, and postoperative complications within and after 30 days after the operation.

Results : Patient characteristics were not significantly different between the two groups. The laparoscopic group had a longer duration of disease before the operation (42.3¡¾48.5 vs. 105¡¾97.6, p=0.019). The operative results, including operation time and estimated blood loss, were not different in both groups. The postoperative outcomes of laparoscopic surgery were not different from those of open surgery in postoperative complications within and after 30 postoperative days. The rate of reoperation and readmission was not different, and the days until first gas passing and soft diet were not significantly different.

Conclusion : Laparoscopic surgery in ulcerative colitis is a feasible and safe procedure. Laparoscopic surgery may provide an alternative approach to open surgery in carefully selected ulcerative colitis patients.
KEYWORD
Ulcerative Colitis, Surgery, Laparoscopy
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