Aim: To assess and compare outcomes of laparoscopic total colectomy performed for a variety of indications.
Methods: Sixty six patients underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre- and post-operative outcomes were collected prospectively.
Results: Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a significantly higher anastomotic leak rate (23.1% vs 1.9%, P < 0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P < 0.05). No significant difference was found in return of gut function and overall morbidity between disease groups.
Conclusion: Laparoscopic total colectomy is feasible and outcomes are equivalent whatever the indication, except for anastomotic leak rate which is higher for patients with IBD.
Keywords: Colectomy; Colonic neoplasms; Constipation; Diverticulosis; Familial adenomatous polyposis; Hereditary nonpolyposis; Inflammatory bowel disease; Laparoscopy; Treatment outcomes.