[Clinical application of laparoscopy-assisted total proctocolectomy using medial-to-lateral approach].
OBJECTIVE
To investigate the safety and feasibility of laparoscopy-assisted total proctocolectomy using medial-to-lateral approach.


METHODS
Between October 2005 and January 2012, 21 consecutive patients underwent laparoscopic-assisted total proctocolectomy by medial-to-lateral approach in Department of General Surgery in Nanfang Hospital. The clinical data and follow-up results were reviewed.


RESULTS
Twenty cases underwent laparoscopic resection successfully, and 1 case (4.8%) was converted to open surgery because of serious peritoneal cavity adhesion. The mean operative time was (237.1±64.2) min and intraoperative blood loss was (90.0±77.7) ml. The mean time to first flatus was (2.7±0.8) days. The mean postoperative hospital stay was (11.8±5.7) days. Three patients (14.3%) experienced postoperative complications, including anastomotic leakage (n=1), lymphatic leakage (n=1), and anastomotic stricture (n=1). The median follow-up was 22 months (4-60 months). There were two deaths including one patient died of progressive disease 5 months after surgery and the other died of multiple organ failure.


CONCLUSIONS
The advantages of laparoscopy-assisted total proctocolectomy using medial-to-lateral approach include simplified surgical procedure, clearly revealed surgical plane, and shortened operative time. This procedure is safe and feasible in the experienced department of laparoscopic colorectal surgery.
Department of General Surgery, Southern Medical University, Guangzhou, China.
Yan
Y
Geng
Yan-feng
YF
Hu
Jiang
J
Yu
Ya-nan
YN
Wang
Xia
X
Cheng
Guo-xin
GX
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult