The researchers determined the safety and efficacy of laparoscopic colectomy in inflammatory bowel disease patients, compared with those undergoing conventional urgent colectomy.
The findings of the study were published in the October issue of the Diseases of the Colon & Rectum.
Patients undergoing laparoscopic total colectomy for acute colitis were identified in a prospective registry.
All subjects underwent a total colectomy with creation of an end ileostomy and buried mucous fistula.
No patient had fulminant disease (tachycardia, fever, marked leukocytosis, peritonitis), but all were failing to respond to medical treatment.
Patients undergoing conventional total colectomy were matched for age, gender, body mass index, diagnosis, disease severity, and operative period.
|Benefits of laparoscopic colectomy:|
- Bowel function returned sooner
- Shorter length of stay
- Fewer complications
| Diseases of the Colon & Rectum |
From 1997 to 1999, there were 19 laparoscopic and 29 matched conventional patients.
There were no inadvertent colotomies or conversions in the laparoscopic group.
The researchers found that there was no difference in operative blood loss in the laparoscopic group (100 ml) when compared with the conventional group (150 ml). However, the operative times were significantly longer in the laparoscopic group (210 vs 120 minutes).
Bowel function returned more quickly in the laparoscopic group (1 vs 2 days) and the length of stay was shorter (4 vs 6 days).
Complications occurred in 3 (16%) laparoscopic patients (2 wound infection and 1 ileus) and in 7 (24%) conventional patients (3 wound infection, 3 deep venous thrombosis, 1 upper gastrointestinal bleed).
Dr Peter W. Marcello, of the Lahey Clinic, Burlington, Massachusetts, concluded on behalf of his colleagues, "Laparoscopic total colectomy is feasible and safe in patients with acute nonfulminant colitis and may lead to a faster recovery than conventional resection."