title: Laparoscopic surgery for ulcerative colitis: a review of the literature.
abstract: Despite the development of new therapies, including anti-TNF alpha antibodies and immunosuppressants, a substantial proportion of patients with ulcerative colitis (UC) still require surgery. Restorative proctocolectomy with ileal-pouch anal anastomosis is the standard surgical treatment of choice for UC. With the advent of laparoscopic techniques for colorectal surgery, ileal-pouch anal anastomosis has also been performed laparoscopically. This paper reviews the history and current trends in laparoscopic surgery for UC. The accumulation of experience and improvement of laparoscopic devices have shifted the paradigm of UC surgery towards laparoscopic surgery over the past decade. Although laparoscopic surgery requires a longer operation, it provides significantly better short and long-term outcomes. The short-term benefits of laparoscopic surgery over open surgery include shorter hospital stays and fasting times, as well as better cosmesis. The long-term benefits of laparoscopy include better fecundity in young females. Some surgeons favor laparoscopic surgery even for severe acute colitis. More efforts are being made to develop newer laparoscopic methods, such as reduced port surgery, including single incision laparoscopic surgery and robotic surgery.
authors.affiliation: Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, khata-tky@umin.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hata
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kazama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nozawa
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kawai
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Kiyomatsu
authors.forename: Junichiro
authors.initials: J
authors.lastname: Tanaka
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ishihara
authors.forename: Eiji
authors.initials: E
authors.lastname: Sunami
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods* / Q000639:trends*; D007902:Length of Stay; D008297:Male; D016737:Proctocolectomy, Restorative / Q000295:instrumentation / Q000379:methods* / Q000639:trends*; D065287:Robotic Surgical Procedures / Q000639:trends; D016896:Treatment Outcome