Laparoscopic total colectomy: Does the indication influence the outcome?

来源 :World Journal of Gastrointestinal Surgery | 被引量 : 0次 | 上传用户:zhuxin1109
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AIM: To assess and compare outcomes of laparoscopic total colectomy performed for a variety of indications. METHODS: Sixty six patients underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre and post-operative outcomes were collected prospectively.RESULTS: Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a signifi cantly higher anastomotic leak rate (23.1% vs 1.9%, P < 0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P < 0.05). No signifi cant difference was found in return of gut function and overall morbidity between disease groups. CONCLUSION: Laparoscopic total colectomy is feasible and outcomes are equivalent whatever the indica- tion, except for anastomotic leak rate which is higher for patients with IBD. METHODS: Sixty underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre and Post-operative outcomes were collected prospectively .RESULTS: Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a signifi cantly higher anastomotic leak rate (23.1% vs 1.9%, P <0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P <0.05). No signifi cant difference was found in return of gut function and overall morbidity between disease groups. CONCLUSION: Laparoscopic total colectomy is feasible and outcomes are equivalent whatever indications- except for anastomotic leak rate which is higher for patients with IBD.
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