title: Technique of laparoscopic-assisted total proctocolectomy and ileal pouch anal anastomosis in children and adolescents: a single center's 8-year experience.
abstract: BACKGROUND
  Laparoscopic techniques have been applied to restorative proctocolectomy since the early 2000s. We have employed a technique for laparoscopic-assisted total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) for the treatment of children with ulcerative colitis (UC).
  
  
  METHODS
  A total of 68 children underwent laparoscopic-assisted TPCs at our institution from June 2003 to February 2011. The patients ranged from 5 to 22 years of age. We progressively modified our surgical approach in positioning, equipment use, and operative technique.
  
  
  RESULTS
  A total of 68 children underwent laparoscopic-assisted TPC within the 8-year time period. Two major complications occurred (2/68=3%) consisting of 1 duodenal injury and 1 small bowel injury. There were 6 minor complications (6/68=9%), including 5 stoma revisions and 1 port site hernia. There were no superficial wound infections. There were no reported cases of pouch fistulas, anastomotic breakdown, or neurovascular injuries.
  
  
  CONCLUSIONS
  Our surgical technique is safe and effective in treating children with UC.
authors.affiliation: Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. bradley.linden@childrens.harvard.edu
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Linden
authors.forename: Sigrid
authors.initials: S
authors.lastname: Bairdain
authors.forename: Robert C
authors.initials: RC
authors.lastname: Shamberger
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.forename: Craig W
authors.initials: CW
authors.lastname: Lillehei
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D001900:Boston; D002648:Child; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome