Abstracts
1999 Digestive Disease Week

# 2092 LAPAROSCOPIC TOTAL ABDOMINAL COLECTOMY: AN APPRAISAL OF 73 CONSECUTIVE CASES.
Kuan S Wong, Peter W Marcello, Cleveland Clin Fdn, Cleveland, OH; Jeffrey D Milsolm, Mount Sinai Hosp, New York, NY

Introduction: Total colectomy is a major procedure performed for a variety of benign colorectal diseases. The aim of this review is to determine the efficacy of laparoscopic techniques in selected patients and disease groups.
Methods: Seventy-three patients(pts) from 1992-1998 underwent intracorporeal mobilization of the colon, division of major vascular pedicles and extraction through a cannula site. Fifty one pts had an ileorectal anastomosis and 22 pts had creation of an end-ileostomy. All data were collected prospectively. The disease groupings included familial polyposis syndromes (FP), inflammatory bowel disease (IBD), active colitis (AC) and slow transit constipation (STC).
Results: There were 42 women and 31 men with a median age of 32 years(range, 10-80). There were 6(8%) conversions due to extensive adhesions in 2 pts, bleeding, morbid obesity, inability to mobilize splenic flexure and difficulty in specimen delivery in 1 patient each. There were no deaths. Minor complications occured in 9 (12%)pts, and major complications in 12 (16%) pts.
Conclusion: Laparoscopic total colectomy is technically feasible and safe in a wide range of colorectal disease entities. Operative and recovery parameters versus disease groupings

Group	OR (min)	EBL (ml)	BM (day)
FP (36)	223(150-395)	150(50-675)	2.0(1-7)
IBD(15)	210(150-380)	200(75-1000)	3.0(1-30)
AC(12)	264(180-460)	200(50-700)	2.5(1-3)
STC(10)	230(180-315)	225(100-400)	3.5(1-5)

OR - operating time; EBL - estimated blood loss; BM - time to 1st bowel movement.

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