Laparoscopically assisted bowel surgery for inflammatory bowel disease. The combined experiences of two academic centers.
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.
Meijerink
W J
WJ
Department of Surgery, Leiden University Medical Center, Albinusdreef 2, Post Office Box 9600, 2300 RC Leiden, The Netherlands.
Eijsbouts
Q A
QA
Cuesta
M A
MA
van Hogezand
R A
RA
Ringers
J
J
Meuwissen
S G
SG
Griffioen
G
G
Bemelman
W A
WA
D000293:Adolescent; D000328:Adult; D003082:Colectomy / Q000379:methods; D003125:Colostomy / Q000379:methods; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods; D015212:Inflammatory Bowel Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies