2005 Abstracts: Results of Laparoscopically Guided and Open Colectomy-Proctomucosectomy in Patients with Ulcerative Colitis and FAP
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Results of Laparoscopically Guided and Open Colectomy-Proctomucosectomy in Patients with Ulcerative Colitis and FAP
Joerg-Peter Ritz, Charite Campus Benjamin Franklin Dept of Surgery I, Berlin, Berlin, Germany; Anton J. Kroesen, Charite Campus Benjamin Franklin, Department of General Surgery, Berlin, Berlin, Germany; Heinz J. Buhr, Charite, Campus Benjamin Franklin, Department of General Surgery, Berlin, Berlin, Germany
Introduction: The treatment of ulcerative colitis (UC) and FAP by colectomy-proctomucosectomy (CPM) is considered a standard procedure. In addition to the standard open procedure, laparoscopically guided surgery has been increasingly performed for these patients. The advantages of the laparoscopic procedure are still controversial because the operation is technically complicated and the underlying disease complex. The aim of this study was to compare the results of laparoscopic and open CPM with regard to peri- and postoperative complications.
Materials and Methods: In context of this study, we recorded all consecutive patients, who underwent a laparoscopic CPM from 01/02 to 10/04. Records were analyzed via prospective data recording (diagnostics, drug history, previous diseases, pre- and intraoperative findings, postoperative course). These patient (group I) were compared to a patient population (group II) that underwent open CPM and did not differ with regard to previous diseases, BMI, age or immunosuppression. Results: A total of 58 patients were included in the study. Depending on the surgical access, 28 patients were assigned to group I (13 f, 15 m; 17-53 years) and 30 (10 f, 20 m; 22-60 years) to group II. The underlying disease was UC in 42 patients and FAP in 16. There were no differences between the two groups with regard to the type of previous disease, BMI, age or sex. Preoperative drug immunosuppression was found in 42% of the pat.. Direct insertion of an anal pouch anastomosis was possible in 22 patients from each group. 50 pat. received a protective ileostoma. Major complications occurred in 16% of group I and 19% of group II. The overall complication rate was 37% in group I and 38.4% in group II. A relaparotomy was required in 3 pat. from each group.| n | CU/ FAP(n) | BMI(kg/qm) | Immunosuppr. (n) | OP duration (Min.) | Analgesia (d) | Hospital time (d) | |
| Group I | 28 | 20 / 8 | 22.4±3.7 | 11 | 285 (160-435) | 4.3 | 21 |
| Group II | 30 | 22 / 8 | 24.2±4.2 | 13 | 224 (120-380)* | 8.7* | 28* |
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