Laparoscope-Assisted Versus Conventional Restorative Proctocolectomy with Rectal Mucosectomy |
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Authors: | Akihiko Hashimoto Yuji Funayama Hiroo Naito Kohei Fukushima Chikashi Shibata Takeshi Naitoh Kazuhiko Shibuya Kaori Koyama Ken-ichi Takahashi Hitoshi Ogawa Shun Satoh Tatsuya Ueno Taku Kitayama Seiki Matsuno Iwao Sasaki |
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Institution: | (1) First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan, JP |
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Abstract: | To assess the advantages of a laparoscope-assisted proctocolectomy with ileal J-pouch anal anastomosis compared with conventional
procedures, we retrospectively analyzed the results of the two procedures as follows: Eleven patients including five patients
with familial adenomatous polyposis (FAP) and six with ulcerative colitis (UC) underwent a laparoscope-assisted proctocolectomy
and hand-sewn ileal J-pouch anal anastomosis at our department from June 1997 to November 1999. This laparoscope-assisted
colectomy (LAC) group was then compared with a group of 13 patients who had undergone conventional ileal pouch anal anastomosis
using a standard laparotomy from 1986 to 1997. The median operative time of the LAC group was 8 h 23 min, which was 81 min
longer than that of the standard colectomy (SC) group. The number of days during which eating was prohibited were similar
in the two groups but the median postoperative hospital stay was significantly shorter in the LAC group (24.1 days). In the
LAC group, the small incisions showed better cosmetic results and there was also a remarkable reduction in the degree of postoperative
pain. In conclusion, a laparoscope-assisted proctocolectomy with ileal J-pouch anal anastomosis can be employed widely in
patients with FAP and also in selected patients with UC.
Received: April 17, 2000 / Accepted: September 26, 2000 |
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Keywords: | Ileal pouch anal anastomosis Laparoscopic colectomy Familial adenomatous coli Ulcerative colitis |
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