PubMed · 981766
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J M Valoria villamartin, C Moreno gonzalez-bueno. 1976. [Elective surgery in ulcerative colitis].. https://pubmed.ncbi.nlm.nih.gov/981766/
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Laparoscopic management of sigmoid diverticular disease has emerged as an important adjunct to the armamentarium of surgical options for this disease process. Although there are no prospective randomized studies directly comparing laparoscopic and open colectomy for diverticulitis, the comparative studies provide compelling data. The magnitude of benefits achieved with laparoscopic colectomy in the hands of experienced laparoscopic colon surgeons may soon be sufficient to make laparoscopic colectomy the standard of care.
Laparoscopic techniques have revolutionized management of colorectal diseases; however, inflammatory diseases of the intestine have proven challenging because of the technical demands of their nature. Intense investigation and subsequent refinements in technique and technology have recently led to considerable advances and a clear role for laparoscopic management of Crohn's disease. and diverticulitis; laparoscopy for ulcerative colitis has not proven as promising. Laparoscopic procedures for ulcerative colitis require a significant learning curve. Although numerous experienced laparoscopic teams have documented their ability to complete them, long operative times and elevated rates of morbidity in some studies appear to counter the advantages. The question remains as to the universal application and appropriateness of these procedures in surgical management of ulcerative colitis.
Crohn's disease (CD) is one of the most challenging arenas of intestinal surgery. Many of its pathological features--intense inflammation, a thickened mesentery, enteric fistulae, and skip areas of intestinal involvement--have justifiably deterred surgeons from considering a laparoscopic approach. Nonetheless, most patients who have CD understand that they have a high (70%-90%) probability of needing surgery at some point; thus they are extremely motivated to undergo an operation that could involve minimal scarring and a faster recovery. This article presents current evidence for the use of laparoscopic techniques to manage Crohn's disease are also discussed.