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Laparoscopic total abdominal colectomy with ileorectal anastomosis for familial adenomatous polyposis. Dis Colon Rectum 1997 Jun;40(6):675-8

Date

06/01/1997

Pubmed ID

9194461

DOI

10.1007/BF02140896

Scopus ID

2-s2.0-0030972861 (requires institutional sign-in at Scopus site)   76 Citations

Abstract

PURPOSE: This study was undertaken to describe our results in a series of patients undergoing total abdominal colectomy with ileorectal anastomosis (TAC/IRA) using laparoscopic techniques in patients with familial adenomatous polyposis (FAP) and rectal-sparing. Young patients with FAP requiring TAC/IRA may be ideal candidates for minimally invasive surgery, because they are generally thin and have benign disease. They might benefit maximally from the theoretic advantages of these techniques.

METHODS: We have performed laparoscopic TAC/IRA in 16 FAP patients (10 females; mean age, 18 years). Procedures were entirely intracorporeal, with a 3-cm to 6-cm specimen extraction incision.

RESULTS: Median operative time was 232 (range, 156-285) minutes, and blood loss 175 (range, 50-675) ml. The only intraoperative complication, a twisted ileorectal anastomosis, was noted intraoperatively and revised. There were no conversions to conventional laparotomy. Median postoperative interval to passage of flatus was three days, and for bowel movements it was three days. Median hospital stay was five days. One case of early postoperative small-bowel obstruction was treated nonoperatively, and one case of brachial plexus neuropraxia resolved spontaneously.

CONCLUSIONS: Based on this preliminary experience, we believe laparoscopic TAC/IRA can be a safe and effective treatment for selected patients with FAP. As techniques and instrumentation for laparoscopic colon surgery are perfected, this procedure will likely become an appealing option in the management of patients with FAP.

Author List

Milsom JW, Ludwig KA, Church JM, Garcia-Ruiz A

Author

Kirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Activities of Daily Living
Adenomatous Polyposis Coli
Adolescent
Adult
Anastomosis, Surgical
Colectomy
Female
Follow-Up Studies
Humans
Ileum
Laparoscopy
Length of Stay
Male
Patient Satisfaction
Quality of Life
Rectum