[Laparoscopic proctocolectomy with ileal pouch-anal anastomosis].
2008
INTRODUCTION: Proctocolectomy with ileal pouch-anal anastomosis (restorative proctocolectomy) became a method of choice in surgical treatment of familial adenomatous polyposis (FAP) and ulcerative colitis (UC) during last years. The improvement of laparoscopic technique in colorectal surgery permit to perform this operation by miniinvasive approach. PATIENTS AND METHOD: Authors present the informations about two patients (one with FAP and one with UC) in whom they perform the laparoscopic proctocolectomy with ileal pouch-anal anastomosis and protective loop ileostomy. RESULTS: Although authors present their first experiences with corresponding operating time (390 and 360 minutes), they noticed hopeful postoperative period with quickly return of bowel movement, early return of oral intake and rapid reconvalescence. They observed one postoperative complication--wound infection. The longer postoperative hospital stay (17 and 19 days) may be related to the consistent management of protective ileostomy and precise postoperative follow-up. CONCLUSION: Restorative proctocolectomy is possible to perform by miniinvasive approach having the adequate experiences with laparoscopic colorectal operations and open procedures for inflammatory bowel diseases. The more procedures experiences allow to consider the benefit of laparoscopic approach for patients.
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