Mid-term functional outcome of laparoscopic restorative proctocolectomy: a prospective study of 40 consecutive cases.
BACKGROUND
This prospective study aimed to analyze the functional outcome after a two-stage laparoscopic total proctocolectomy with ileal pouch-anal anastomosis.


METHODS
From May 1999 to May 2008, 68 consecutive two-stage laparoscopic total proctocolectomies with ileal pouch-anal anastomosis were performed (ulcerative colitis: n = 61; familial adenomatous polyposis: n = 7). A covering ileostomy was used in all patients. Forty patients whose covering ileostomy had been closed for a minimum of 2 years were included in this series.


RESULTS
Conversion to laparotomy was necessary in 4 of 40 patients (10%). Thirteen postoperative complications occurred in 13 of 40 patients (30%). At a median follow-up of 38 months (range, 26-90), the median number of bowel movements was 4 per 24 hours (range, 2-10); 15 patients (38%) had no nighttime bowel movements. None of the patients had fecal incontinence or urgency. Thirty-four of the 40 patients (85%) experienced no soiling. Seven patients (18%) took regular antidiarrheal medication. All patients were able to resume all activities practiced prior to illness onset, and 36 of 40 (90%) were satisfied with their overall quality of life (very good or good).


CONCLUSIONS
Laparoscopic total proctocolectomy with ileal pouch-anal anastomosis provides satisfying mid-term functional outcome.
Berdah
Stephane V
SV
Department of Digestive Diseases, Hôpital Nord, Marseille, France. stephane.berdah@ap-hm.fr
Mardion
Rémi Bon
RB
Grimaud
Jean-Charles
JC
Barthet
Marc
M
Orsoni
Pierre
P
Moutardier
Vincent
V
Brunet
Christian
C
D011125:Adenomatous Polyposis Coli / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000473:pathology / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult