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PubMed · 15593294

Laparoscopic restorative proctocolectomy.

P Kienle·K Z'graggen·J Schmidt·A Benner·J Weitz·M W Büchler
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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.

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Adenomatous Polyposis ColiAdolescentAdultBlood Loss, SurgicalBody Mass IndexColitis, UlcerativeFeasibility StudiesFemaleHumansLaparoscopyLength of StayMaleMiddle AgedPostoperative ComplicationsProctocolectomy, RestorativeProspective StudiesPlastic Surgery ProceduresRegression AnalysisReoperationRisk FactorsTreatment OutcomeJournal Article

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BibTeXRIS

P Kienle, K Z'graggen, J Schmidt, A Benner, J Weitz, M W Büchler. 2005. Laparoscopic restorative proctocolectomy.. https://doi.org/10.1002/bjs.4772

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