The potential benefits and disadvantages of laparoscopic surgery for ulcerative colitis: A review of current evidence.
Up to 35% of patients with ulcerative colitis will require surgery during the course of their disease. Nowadays, a total colectomy with ileal pouch-anal anastomosis is the preferred procedure, which can be performed open or via laparoscopic approach. Since the early '90s, minimally invasive techniques have gained popularity, but the extend of restorative procedures in these patients has restricted the use of laparoscopic approaches mainly to elective procedures in specialised centres. This review discusses the benefits and disadvantages of laparoscopic surgery when compared to open surgery. It presents the current evidence on short-term and long-term post-operative results, functional outcome, fecundity, and costs, for both elective and emergency indications. In addition, the value of new techniques (including single port surgery) and alternative laparoscopic approaches (e.g. ileo-rectal anastomosis, Kock-pouch and appendectomy) will be discussed.
Department of Surgery, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands. Electronic address: c.j.buskens@amc.uva.nl.
Christianne J
CJ
Buskens
Department of Surgery, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Saloomeh
S
Sahami
Department of Surgery, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Pieter J
PJ
Tanis
Department of Surgery, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Willem A
WA
Bemelman
D001062:Appendectomy / Q000191:economics / Q000379:methods*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D039021:Colonic Pouches; D003362:Cost-Benefit Analysis; D017558:Elective Surgical Procedures; D004630:Emergencies; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics; D011183:Postoperative Complications / Q000517:prevention & control; D016737:Proctocolectomy, Restorative / Q000191:economics / Q000379:methods*; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
Ileal-anal pouch; Laparoscopy; Proctocolectomy; Ulcerative colitis