title: A comparison of laparoscopic and open restorative proctocolectomy in children.
abstract: OBJECTIVE
  Restorative proctocolectomy (RP) is the gold standard for children requiring removal of their colon and rectum. The aim of this study is to contrast conventional (open) and laparoscopic RP.
  
  
  METHODS
  All children undergoing RP by one surgeon were prospectively recorded in a customised database. Outcome variables were length of stay in days (LOS), duration of surgery in minutes (DS), blood loss in ml, and complications. Explanatory variables included technique of resection (open or laparoscopic (lap)) and presenting disease. Lap resection was adopted after patient 37. Data are presented as median (range). P<0.05 was regarded as significant.
  
  
  RESULTS
  Eighty-two (43 girls) children underwent RP at median age 12 (0.5-20) years. RP was performed as Open (n=37) or Laparoscopic (n=45). Indications were: colitis (n=56), polyposis (n=12), constipation (n=7), Hirschsprung's (n=5), fibrosing colonopathy (n=2). Significantly, more children had three-stage surgery among the lap group (P =0.04). LOS was significantly shorter in the lap group [15 (8-114) days vs 17(13- 60) days; P=0.04], but there was no difference in DS or complication rates between laparoscopic and open surgery. Laparoscopic surgery was associated with significantly lower blood loss [150 (0-840) ml vs. 334 (0-1480) ml; P=0.02].
  
  
  CONCLUSIONS
  Laparoscopic RP is associated with lower blood loss, shorter LOS, but no difference in duration of surgery or complication rate.
authors: Department of Paediatric Surgery, The Great North Children's Hospital, Newcastle upon Tyne, UK.
authors: Jigna
authors: J
authors: Sheth
authors: Department of Paediatric Surgery, The Great North Children's Hospital, Newcastle upon Tyne, UK. Electronic address: bruce.jaffray@nuth.nhs.uk.
authors: Bruce
authors: B
authors: Jaffray
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Children; Laparoscopy; Restorative proctocolectomy