title: Surgical outcomes of laparoscopic colorectal resections for familial adenomatous polyposis.
abstract: BACKGROUND
  Acceptance of extended laparoscopic colon resections is still controversial besides the growing experience over the years.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the postoperative outcomes of laparoscopic colorectal resections exclusively for familial adenomatous polyposis patients.
  
  
  METHODS
  Patient data, surgical procedures and operative outcomes from 49 patients submitted to total proctocolectomy (TPC) or total abdominal colectomy (TAC) from 1997 to 2009 were prospectively analyzed.
  
  
  RESULTS
  There were 18 (36.7%) men and 31 (63.3%) women, with a median age of 31.1 years. Surgical procedures consisted of 3 TPC with ileostomy (6.1%), 30 restorative TPC with ileoanal anastomosis (61.2%), and 16 TAC with ileorectal anastomosis (32.6%). Only 1 patient (2.0%) required open conversion. No patient required blood transfusion. Median operating time was 289, ranging from 150 to 400 minutes. Twelve patients (24.5%) presented complications and only 1 (2.0%) died. Overall complication rates were similar after TAC or TPC (31.2% vs. 21.2%; P=0.4). Reoperations were necessary in 7 cases (14.3%), and the median length of hospital stay was 6.2 days (3 to 16). The comparison of 2 consecutive groups of patients over time revealed a little improvement in surgery duration (301 to 276 min; P=0.16), but relevant reduction in morbidity (32% vs. 16.6%; P=0.2) and reoperation rates (20% vs. 8.3%; P=0.4), besides the absence of statistical difference.
  
  
  CONCLUSIONS
  Laparoscopic TPC and TAC represent an interesting alternative approach for young and motivated familial adenomatous polyposis patients. When performed by experienced surgeons, they provide excellent short-term outcome regarding immediate recovery, morbidity, and cosmesis.
authors: Gastroenterology Department, Colorectal Unit, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. fgmcampos@terra.com.br
authors: Fábio Guilherme
authors: FG
authors: Campos
authors: Sérgio Eduardo
authors: SE
authors: Araújo
authors: Armando Geraldo
authors: AG
authors: Melani
authors: Luís Cláudio
authors: LC
authors: Pandini
authors: Sérgio Carlos
authors: SC
authors: Nahas
authors: Ivan
authors: I
authors: Cecconello
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000453:epidemiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003082:Colectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult