Laparoscopic 3-step restorative proctocolectomy: comparative study with open approach in 45 patients.
BACKGROUND
To compare the results of a total laparoscopic versus open approach 3-time ileal pouch anal anastomosis (IPAA) for patients with acute or severe colitis complicating inflammatory bowel disease.


METHODS
Consecutive subtotal colectomy was followed by IPAA then by stoma closure. Between 2000 and 2006, 23 consecutive patients, operated through a total laparoscopic approach were well matched with 22 patients operated by open approach.


RESULTS
Overall major complications rate was lower after laparoscopic than after open approach (5/23 vs. 9/22; NS). Mean hospital stay for the 3 consecutive procedures was significantly reduced after laparoscopic versus open approach (27+/-7 d vs. 39+/-27 d; P<0.05).


CONCLUSIONS
Our case-control study suggests that, in experienced centers, a total laparoscopic approach can be viewed as a viable alternative to conventional open 3-step IPAA for the treatment of acute or severe colitis complicating inflammatory bowel disease.
Ouaïssi
Mehdi
M
Department of Colorectal Surgery, PMAD, Beaujon Hospital (APHP), Clichy, France.
Lefevre
Jérémie H
JH
Bretagnol
Fréderic
F
Alves
Arnaud
A
Valleur
Patrice
P
Panis
Yves
Y
D000328:Adult; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome