A Case-matched Comparative Study of Laparoscopic and Open Total Proctocolectomy for Ulcerative Colitis.
The aim of this single-institution, retrospective, observational case-control study was to evaluate the safety and feasibility of laparoscopic proctocolectomy (PC) for ulcerative colitis (UC), by comparing it with a case-control series of open PC. Twenty UC patients who underwent laparoscopic PC were retrospectively compared with the open PC group of 12 patients matched for age, sex, and urgency of the operation. In the laparoscopic PC group, the operative time was significantly longer, but the amount of blood loss was significantly smaller. The open PC patients underwent an intraoperative blood transfusion significantly more often, and the serum C-reactive protein level on the first postoperative day was significantly higher in the open PC group. In the laparoscopic PC group, the rate of severe postoperative morbidities, grades 3 and 4 on the Clavien-Dindo classification, was significantly lower, and the median length of hospital stay was significantly shorter. Laparoscopic PC for patients with UC showed superior perioperative outcomes to open PC, except for longer operative time.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.ryo_inada@hotmail.com.
Ryo
R
Inada
Takeshi
T
Nagasaka
Yoshitaka
Y
Kondo
Ayako
A
Watanabe
Toshiaki
T
Toshima
Nobuhito
N
Kubota
Satoru
S
Kikuchi
Michihiro
M
Ishida
Shinji
S
Kuroda
Yoshiko
Y
Mori
Hiroyuki
H
Kishimoto
Toshiyoshi
T
Fujiwara
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods*