Literature DB >> 19037931

Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay.

E Boyle1, P F Ridgway, F B Keane, P Neary.   

Abstract

OBJECTIVE: Laparoscopic surgery for inflammatory bowel disease (IBD) is technically demanding but can offer improved short-term outcomes. The introduction of minimally invasive surgery (MIS) as the default operative approach for IBD, however, may have inherent learning curve-associated disadvantages. We hypothesise that the establishment of MIS as the standard operative approach does not increase patient morbidity as assessed in the initial period of its introduction into a specialised unit, and that it confers earlier postoperative gastrointestinal recovery and reduced hospitalisation compared with conventional open resection.
METHOD: A case-control study was undertaken on laparoscopic resection (LR) vs open colon resection (OR) for IBD. The LR group was collated prospectively and compared with a pathologically matched historical control set. Outcomes measured included: postoperative length of stay, time to normal bowel function and postoperative morbidity. Statistical analysis was performed using spss.
RESULTS: Twenty-eight patients were investigated (14 LR, 14 OR). The two groups were matched for type of operation, type of disease and age. There were no conversions in the LR group. Morbidity and readmissions did not differ significantly between the groups. Those undergoing laparoscopic resection had a quicker return to diet (median 2 vs 4 days; P = 0.000002), time to first bowel motion (2 vs 4 days; P = 0.019) and shorter postoperative length of stay (5.5 vs 12.5; P = 0.0067).
CONCLUSION: These findings support the routine use of MIS for the elective surgical management of IBD in our department. Patients undergoing laparoscopic colectomies for IBD can expect faster return of gastrointestinal function and shorter hospitalisation.

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Mesh:

Year:  2008        PMID: 19037931     DOI: 10.1111/j.1463-1318.2008.01518.x

Source DB:  PubMed          Journal:  Colorectal Dis        ISSN: 1462-8910            Impact factor:   3.788


  6 in total

1.  Short-term outcomes following laparoscopic resection for colon cancer.

Authors:  Dara O Kavanagh; David Gibson; Diarmaid C Moran; Myles Smith; Kate O Donnell; Emmanuel Eguare; Frank B V Keane; Diarmaid S O Riordain; Paul C Neary
Journal:  Int J Colorectal Dis       Date:  2010-10-23       Impact factor: 2.571

2.  The benefit of an enhanced recovery programme following elective laparoscopic sigmoid colectomy.

Authors:  Hasan Al Chalabi; Dara O Kavanagh; Lana Hassan; Kate O Donnell; Emmeline Nugent; Emmet Andrews; Frank B V Keane; Diarmuid S O'Riordain; Andrew Miller; Paul Neary
Journal:  Int J Colorectal Dis       Date:  2010-02-23       Impact factor: 2.571

3.  Comparable postoperative morbidity and mortality after laparoscopic and open emergent restorative colectomy: outcomes from the ACS NSQIP.

Authors:  Nikiforos Ballian; Natalie Weisensel; Victoria Rajamanickam; Eugene F Foley; Charles P Heise; Bruce A Harms; Gregory D Kennedy
Journal:  World J Surg       Date:  2012-10       Impact factor: 3.352

4.  Laparoscopic subtotal colectomy for medically refractory ulcerative colitis: the time has come.

Authors:  Dana A Telem; Anthony J Vine; Garry Swain; Celia M Divino; Barry Salky; Adrian J Greenstein; Michael Harris; L Brian Katz
Journal:  Surg Endosc       Date:  2010-03-05       Impact factor: 4.584

Review 5.  Rectal cancer surgery: volume-outcome analysis.

Authors:  Emmeline Nugent; Paul Neary
Journal:  Int J Colorectal Dis       Date:  2010-07-27       Impact factor: 2.571

6.  Laparoscopic resection for inflammatory bowel disease: outcomes from a nationwide sample.

Authors:  Ashwin N Ananthakrishnan; Emily L McGinley; Kia Saeian; David G Binion
Journal:  J Gastrointest Surg       Date:  2009-09-17       Impact factor: 3.452

  6 in total

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