Acceptable short-term outcome of laparoscopic subtotal colectomy for inflammatory bowel disease.
2013
INTRODUCTION: Laparoscopic colectomy for both benign and malignant disease, including inflammatory bowel disease (IBD), has recently been shown to have many advantages compared with open surgery. This study aimed to compare the effect of laparoscopic versus open subtotal colectomy (STC) for IBD on overall morbidity. MATERIAL AND METHODS: A total of 99 patients undergoing STC for IBD at our institution from 2007 through 2011 were identified. Patients undergoing open STC were compared with patients undergoing laparoscopic STC. Outcomes included 30-day morbidity, conversion to laparotomy, intraoperative blood loss, operative time, admission time, late onset complications and 30-day mortality. Results are presented as median values. RESULTS: A total of 57 patients underwent open STC (Group 1) and 42 patients laparoscopic STC (Group 2). Group 1 comprised 26 males and 31 females, with a median age of 35 years and a body mass index (BMI) of 23.2 kg/m2. Group 2 comprised 18 males and 24 females, with a median age of 34 years and a BMI of 23.5 kg/m2. Group 2 had less morbidity (42.9% versus 75.4%, p < 0.002), reduced blood loss (100 ml versus 200 ml, p < 0.001), longer operative time (193.5 min. versus 128 min., p < 0.001), shorter length of hospital stay (six days versus 16 days, p < 0.001) than Group 1. One patient died (Group 1). There was no difference in late onset complications and no conversions to laparotomy in the laparoscopic group. CONCLUSION: Laparoscopic STC has a longer operative time, but improves short-term outcomes compared with open surgery. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
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