BACKGROUND: Laparoscopic bowel surgery was evaluated in 44 consecutive patients who underwent surgery for inflammatory bowel disease (IBD). We studied feasibility, results, and final outcome. METHODS: At two academic institutes, 44 laparoscopically assisted colectomies and laparoscopic ileostomies or colostomies were attempted. All patients had histologically proven IBD and no prior surgery for IBD. Loop ileostomy (n = 4), end colostomy (n = 1), ileocecal resection (n = 26) and (procto)colectomy (n = 13) were performed. All resections were laparoscopically assisted with extracorporal resection and anastomosis. RESULTS: Only in two patients (ileocecal resection in both) was conversion to open surgery necessary. Two patients with laparoscopic ileocolic resection had intra-abdominal abscesses, which were drained percutaneously in both. One patient in the laparoscopically assisted colectomy group had a subphrenic abscess that was drained percutaneously, and one patient had a generalized candidiasis. CONCLUSIONS: Laparoscopically assisted colectomies can be performed safely in treating IBD. The laparoscopic method with use of a small vertical umbilical or Pfannenstiel's incision seems acceptable with regard to operating time and overall costs, also allowing superior cosmesis to be maintained.
BACKGROUND: Laparoscopic bowel surgery was evaluated in 44 consecutive patients who underwent surgery for inflammatory bowel disease (IBD). We studied feasibility, results, and final outcome. METHODS: At two academic institutes, 44 laparoscopically assisted colectomies and laparoscopic ileostomies or colostomies were attempted. All patients had histologically proven IBD and no prior surgery for IBD. Loop ileostomy (n = 4), end colostomy (n = 1), ileocecal resection (n = 26) and (procto)colectomy (n = 13) were performed. All resections were laparoscopically assisted with extracorporal resection and anastomosis. RESULTS: Only in two patients (ileocecal resection in both) was conversion to open surgery necessary. Two patients with laparoscopic ileocolic resection had intra-abdominal abscesses, which were drained percutaneously in both. One patient in the laparoscopically assisted colectomy group had a subphrenic abscess that was drained percutaneously, and one patient had a generalized candidiasis. CONCLUSIONS: Laparoscopically assisted colectomies can be performed safely in treating IBD. The laparoscopic method with use of a small vertical umbilical or Pfannenstiel's incision seems acceptable with regard to operating time and overall costs, also allowing superior cosmesis to be maintained.
Authors: Stefan Maartense; Michalda S Dunker; J Frederick Slors; Miguel A Cuesta; Dirk J Gouma; Sander J van Deventer; Ad A van Bodegraven; Willem A Bemelman Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: Stefan Maartense; Mich S Dunker; J Frederik M Slors; Miguel A Cuesta; Erik G J M Pierik; Dirk J Gouma; Daan W Hommes; Miriam A Sprangers; Willem A Bemelman Journal: Ann Surg Date: 2006-02 Impact factor: 12.969