Total Colectomy and Proctocolectomy: Hand-Assisted Laparoscopic Approach

2014 ◽  
pp. 189-197 ◽  
Author(s):  
Marco Ettore Allaix ◽  
Mukta Katdare Krane ◽  
Alessandro Fichera
Keyword(s):  
Total Colectomy ◽  
Laparoscopic Approach

Entirely Robot-assisted Total Colectomy/Total Proctocolectomy Compared With a Laparoscopic Approach

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jin Cheon Kim ◽  
Jong Lyul Lee ◽  
Yong Sik Yoon ◽  
Hyung Min Kim ◽  
Chan Wook Kim ◽  
...  
Keyword(s):  
Total Colectomy ◽  
Laparoscopic Approach ◽  
Total Proctocolectomy ◽  
Robot Assisted

scholarly journals Laparoscopic Proctocolectomy for Ulcerative Colitis and Crohn’s Disease of the Large Intestine: Short-Term and Long-Term Outcomes of 53 Cases

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
M D Kucher ◽  
L S Bilianskyi ◽  
M I Kryvoruk ◽  
F H Tkachenko ◽  
A I Stelmakh
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Large Intestine ◽  
Ileal Pouch ◽  
Total Colectomy ◽  
Laparoscopic Approach ◽  
Anal Anastomosis ◽  
Terminal Ileostomy ◽  
Laparoscopic Proctocolectomy

One- or two-stage restorative total colectomy is recognized as surgery of choice when treating ulcerative colitis and Crohn’s disease of the large intestine. The possible advantages of laparoscopic approach are still being discussed. The objective of the research was to evaluate postoperative quality of life, short-term and long-term functional outcomes of 53 cases of laparoscopically assisted proctocolectomy for ulcerative colitis and Crohn’s disease of the large intestine in order to improve further application of laparoscopic approach.  Materials and methods. Primary restorative proctocolectomy with transanal mucosectomy and the ileal pouch-anal anastomosis was performed in 5 patients with ulcerative colitis; total colectomy with low anterior resection of the rectum and double stapling ileal pouch-rectal anastomosis was performed in 8 patients; total proctocolectomy (with abdominoperineal resection of the rectum, terminal ileostomy) was performed in 3 patients with Crohn’s disease and multiple perianal fistulas; total colectomy, low anterior resection of the rectum, and terminal ileostomy (the first stage of surgical treatment) was performed in 37 patients; the second stage restorative surgery (J-pouch construction and the pouch-anal/low rectal anastomosing) was performed in 17 patients. The restorative procedure was followed by temporary diverting ileostomy in all patients.Results. The conversion to laparotomy was required in 3 (5.7%) cases. In one case during the second stage restorative surgery the urine bladder wall was damaged, and sutured laparoscopically. There was no postoperative mortality. The major complications of the early postoperative period included pelvic abscesses (4 patients), pouch-anal anastomosis leakage (1 patient), postoperative ileus (3 patients), and ileal pouch-perineal fistula (1patient). Stool frequency was about 6 times in a 24 hour period (4-11 times) 12 months after ileostomy closure.  Pouchitis was observed in 4 patients. Pouch failure occurred in 1 patient due to severe pouchitis and anal incontinence.Conclusions. Laparoscopic proctocolectomy with extracorporeal ileal pouch construction, transanal mucosectomy, and pouch-anal anastomosis are considered as surgery of choice for ulcerative colitis. The pouch-rectal anastomosing is feasible for Crohn’s disease in individual cases. Total laparoscopic proctocolectomy with intracorporeal ileal pouch construction may be the next step in clinical trials.

scholarly journals Comparison of defecatory function after laparoscopic total colectomy and ileorectal anastomosis versus a traditional open approach

2018 ◽  
Vol 100 (3) ◽  
pp. 235-239 ◽  
Author(s):  
MAS Khan ◽  
D Jayne ◽  
R Saunders
Keyword(s):  
Colorectal Cancer ◽  
Small Bowel ◽  
Ileorectal Anastomosis ◽  
Total Colectomy ◽  
Postoperative Bleeding ◽  
Laparoscopic Approach ◽  
Paediatric Surgery ◽  
Open Approach ◽  
Defecatory Function ◽  
Significant Difference

Introduction Total colectomy and ileorectal anastomosis can result in significant defecatory frequency and poor bowel function. The aim of this study was to assess whether a laparoscopic approach is associated with any improvement in this regard. Methods A single institution retrospective review was undertaken of patients undergoing elective total colectomy and ileorectal anastomosis between 2000 and 2011. Those undergoing emergency surgery and paediatric surgery were excluded. The primary outcome measure was satisfactory defecatory function after surgery. Results Forty-nine patients (24 male, 25 female) were included in the study. The median age was 48 years (range: 20–83 years). Laparoscopic total colectomy (LTC) was performed in 20 patients and open total colectomy (OTC) in 29 patients. Indications for surgery were slow colonic transit (n=17), colorectal cancer (CRC) (n=17), CRC with hereditary colorectal cancer syndrome (n=8), inflammatory bowel disease (n=4) and diverticular disease (n=3). In the LTC group, 85% had a satisfactory defecatory frequency of 1–6 motions per day compared with 45% in the OTC cohort (p=0.006). There was no statistically significant difference in bowel frequency related to primary pathology (benign vs cancer surgery, p=1.0). Postoperative complications for both groups included relaparotomy (n=3), anastomotic leak (n=2), small bowel obstruction (n=2), postoperative bleeding (n=1) and pneumonia (n=1). Conclusions This study indicates that long-term defecatory function is better following LTC than following OTC and ileorectal anastomosis. The mechanism for this improvement is unclear but it may relate to the underlying reason for surgery or possibly to reduced small bowel handling leading to fewer adhesions after laparoscopic surgery.

Laparoscopic Approach to Pancreatic Disease

2004 ◽  
Vol 14 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Adrian Park ◽  
Gina L Adrales
Keyword(s):  
Laparoscopic Approach ◽  
Pancreatic Disease

Primary laparoscopic approach to repair perforated peptic ulcer. A retrospective cohort study

2020 ◽  
Vol 75 (6) ◽  
Author(s):  
Gianrocco Manco ◽  
Stefania Caramaschi ◽  
Giovanni Rolando ◽  
Marzio Malagoli ◽  
Giuliana Zanelli ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Laparoscopic Approach ◽  
Perforated Peptic Ulcer

scholarly journals High incidence of postoperative silent venous thromboembolism in ulcerative colitis: a retrospective observational study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Norimitsu Shimada ◽  
Hiroki Ohge ◽  
Hiroki Kitagawa ◽  
Kosuke Yoshimura ◽  
Norifumi Shigemoto ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Venous Thromboembolism ◽  
Total Colectomy ◽  
Univariate Analysis ◽  
Operation Time ◽  
High Serum ◽  
Total Proctocolectomy ◽  
Colon And Rectum ◽  
Predictive Risk ◽  
D Dimer

Abstract Background The incidence of postoperative venous thromboembolism (VTE) is high in patients with inflammatory bowel disease. We aimed to analyze the incidence and predictive factors of postoperative VTE in patients with ulcerative colitis. Methods Patients with ulcerative colitis who underwent colon and rectum surgery during 2010–2018 were included. We retrospectively investigated the incidence of postoperative VTE. Results A total of 140 colorectal surgery cases were included. Postoperative VTE was detected in 24 (17.1 %). Portal–mesenteric venous thrombosis was the most frequent VTE (18 cases; 75 %); of these, 15 patients underwent total proctocolectomy (TPC) with ileal pouch–anal anastomosis (IPAA). In univariate analysis, VTE occurred more frequently in patients with neoplasia than in those refractory to medications (27.2 % vs. 12.5 %; p < 0.031). TPC with IPAA was more often associated with VTE development (28 %) than total colectomy (10.5 %) or proctectomy (5.9 %). On logistic regression analysis, TPC with IPAA, total colectomy, long operation time (> 4 h), and high serum D-dimer level (> 5.3 µg/mL) on the day following surgery were identified as predictive risk factors. Conclusions Postoperative VTE occurred frequently and asymptomatically, especially after TPC with IPAA. Serum D-dimer level on the day after surgery may be a useful predictor of VTE.

scholarly journals Laparoscopic versus open distal pancreatectomy: a single centre propensity score matching analysis

2021 ◽  
Author(s):  
Riccardo Casadei ◽  
Carlo Ingaldi ◽  
Claudio Ricci ◽  
Laura Alberici ◽  
Emilio De Raffele ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Pancreatic Neoplasms ◽  
Postoperative Morbidity ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Single Centre ◽  
Oncological Outcomes ◽  
Open Distal Pancreatectomy

AbstractThe laparoscopic approach is considered as standard practice in patients with body-tail pancreatic neoplasms. However, only a few randomized controlled trials (RCTs) and propensity score matching (PSM) studies have been performed. Thus, additional studies are needed to obtain more robust evidence. This is a single-centre propensity score-matched study including patients who underwent laparoscopic (LDP) and open distal pancreatectomy (ODP) with splenectomy for pancreatic neoplasms. Demographic, intra, postoperative and oncological data were collected. The primary endpoint was the length of hospital stay. The secondary endpoints included the assessment of the operative findings, postoperative outcomes, oncological outcomes (only in the subset of patients with pancreatic ductal adenocarcinoma-PDAC) and total costs. In total, 205 patients were analysed: 105 (51.2%) undergoing an open approach and 100 (48.8%) a laparoscopic approach. After PSM, two well-balanced groups of 75 patients were analysed and showed a shorter length of hospital stay (P = 0.001), a lower blood loss (P = 0.032), a reduced rate of postoperative morbidity (P < 0.001) and decreased total costs (P = 0.050) after LDP with respect to ODP. Regarding the subset of patients with PDAC, 22 patients were analysed: they showed a significant shorter length of hospital stay (P = 0.050) and a reduction in postoperative morbidity (P < 0.001) after LDP with respect to ODP. Oncological outcomes were similar. LDP showed lower hospital stay and postoperative morbidity rate than ODP both in the entire population and in patients affected by PDAC. Total costs were reduced only in the entire population. Oncological outcomes were comparable in PDAC patients.

Sign in / Sign up

Export Citation Format

Share Document