Laparoscopic restorative proctocolectomy technical notes and postoperative results.
2012
Laparoscopic colon surgery has become a proved method for the resection of
both benign and malignant disease. With the advance of technological
innovations and surgical experience, more complex laparoscopic procedures
including restorative proctocolectomy have become increasingly used in the
treatment of ulcerative colitis with safe and feasible results. When these
operations are realized in a stepwise fashion, the complexity of the
procedure becomes simplified. The technical aspects of laparoscopic
restorative proctocolectomy in patients with ulcerative colitis are reviewed
in this article. A J-pouch with a stapled anastomosis has been the preferred
technique because it is quicker and safer. In all patients diverting loop
ileostomy is regularly created at the time of ileal pouch-anal anastomosis.
In this review the postoperative results are also revised. Postoperative
fasting time, postoperative hospital stay, and overall complication rate are
in favor of laparoscopic technique when compared to open approach. However,
clinical value of laparoscopic surgery for ulcerative colitis needs further
evaluation with more well-designed randomized controlled trials along with
long-term follow-up.
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