title: Mid-term functional outcome of laparoscopic restorative proctocolectomy: a prospective study of 40 consecutive cases.
abstract: 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.
authors.affiliation: Department of Digestive Diseases, Hôpital Nord, Marseille, France. stephane.berdah@ap-hm.fr
authors.forename: Stephane V
authors.initials: SV
authors.lastname: Berdah
authors.forename: Rémi Bon
authors.initials: RB
authors.lastname: Mardion
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Grimaud
authors.forename: Marc
authors.initials: M
authors.lastname: Barthet
authors.forename: Pierre
authors.initials: P
authors.lastname: Orsoni
authors.forename: Vincent
authors.initials: V
authors.lastname: Moutardier
authors.forename: Christian
authors.initials: C
authors.lastname: Brunet
mesh_terms: 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