Role of laparoscopic surgery in the treatment of ulcerative colitis; short- and mid-term results

Scand J Gastroenterol. 2015 Apr;50(4):406-12. doi: 10.3109/00365521.2014.985705. Epub 2015 Jan 23.

Abstract

Objectives: Laparoscopy is used more widely for the surgery of ulcerative colitis. The objective of this study was a comparison of the surgical and 3-year follow-up results of patients treated with conventional and minimally invasive methods.

Materials and methods: A total of 45 patients received surgery for ulcerative colitis, 16 as emergency and 29 as elective cases. Laparoscopy was used in 23 and a conventional method in 22 cases. No difference was found between the two groups from the aspects of American Society of Anesthesiologists physical status (ASA) class, mean body mass index (BMI) and age. There were 4 emergency cases in the laparoscopy group, and 12 in the open group. Nineteen elective surgeries were performed in the laparoscopy group, and 10 in the open group.

Results: There was no significant difference between the groups as concerns the length of hospital or intensive care unit (ICU) stay, the time to bowel function recovery, but the duration of open surgery was significantly shorter. There was no difference between the groups in the rate of early postoperative complications, whereas among potential late complications, the rates of intestinal obstruction (8.7% vs. 45%) and a septic condition (0% vs. 27%) were significantly lower in the laparoscopy group. There was a significant improvement in the quality of life after surgery in both groups, and better cosmetic results were observed in the laparoscopy group.

Conclusion: Laparoscopy can be used for ulcerative colitis both emergency and elective cases, it provides a good quality of life and the mid-term rate of complications is lower as compared with open surgery.

Keywords: ileal pouch-anal anastomosis; laparoscopy; proctocolectomy; ulcerative colitis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Colitis, Ulcerative / surgery*
  • Elective Surgical Procedures
  • Emergencies
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Obstruction / etiology
  • Laparoscopy* / adverse effects
  • Male
  • Middle Aged
  • Operative Time
  • Proctocolectomy, Restorative / adverse effects
  • Proctocolectomy, Restorative / methods*
  • Quality of Life
  • Sepsis / etiology
  • Time Factors