Laparoscopic-assisted vs open colectomy for severe acute colitis in patients with inflammatory bowel disease (IBD): a retrospective study in 42 patients.
BACKGROUND
Inflammatory bowel disease (IBD) can be complicated by severe acute colitis. Emergency colectomy is mandatory if patients do not respond to intensive medical therapy. A minimally invasive approach such as laparoscopic-assisted colectomy might be beneficial in these patients. Therefore, we set out to assess the feasibility and the safety of emergency laparoscopic-assisted colectomy in IBD patients with severe acute colitis.


METHODS
A total of 42 consecutive patients underwent an emergency colectomy with end-ileostomy. Ten patients had laparoscopic-assisted colectomy, and 32 had open colectomy. Pre- and perioperative parameters, morbidity, and mortality were analyzed.


RESULTS
The two groups were comparable for patient characteristics. There were no conversions in the laparoscopic group. The operation time was longer in the laparoscopic group than in the open group (271 vs 150 min; p < 0.001), but the hospital stay was shorter (14.6 vs 18.0 days; p = 0.05). Complications were similar for the two groups.


CONCLUSIONS
Laparoscopic-assisted colectomy in IBD patients with severe acute colitis is feasible and as safe as open colectomy.
Dunker
M S
MS
Department of Surgery, Academic Medical Center, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands.
Bemelman
W A
WA
Slors
J F
JF
van Hogezand
R A
RA
Ringers
J
J
Gouma
D J
DJ
D000208:Acute Disease; D000328:Adult; D003082:Colectomy / Q000379:methods*; D003092:Colitis / Q000209:etiology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012720:Severity of Illness Index