The Clinical Use Of Laparoscopic Total Colectomy

Objective: To evaluate the safety, feasibility and clinical value of laparoscopic total colectomy in treating colonic and rectal disease: familial adenomatous polyposis (FAP),ulcerative colitis(UC), and extensive hemangioma of colorectum. Methods: Retrospectively review the clinic data of 7 patients underwent laparoscopic total colectomy in Qilu Hospital of Shandong University between Feb.2004 and Dec. 2005. Four cases of FAP patients were operated on laparoscopic total colectomy with ileal pouch rectal anastomosis +endoscopic porctopolypus cautery. One case of FAP with rectal cancenzation was performed laparoscopic total colectomy with ileal pouch rectal anastomosis +TME, +endoscopic porctopolypus cautery . One case of UC received laparoscopic proctocolectomy with ileal pouch anal anastomosis.One case of extensive hemangioma of colorectum underwent laparoscopic most proctocolectomy, sigmoid colon-ileum anastomosis, sigmoid colon-rectum anastomosis . Results: All cases were performed laparoscopic total colectomy successfully. There were no intraoperative complications and conversation to open procedure. Average operating time was 305min (range, 250～420minutes), average blood loss was 150ml (range ,110～200ml). The postoperative hospitlization was 8.4 days (range ,7～ 10days). Incision length was 5cm (range, 4.5～5.6cm). The mean return of bowel function was 2.4 days(1～3days). Postoperative complications occurred in 2 patients(1 case with shoulder pain and 1 case with urine retention). No patients had anastomotic leakage or straitness. The follow-up was available for a period ranging from 3 to 12 months. Average time was 6 months. There was no bowel obstruction occurred. Functional outcome and quality of life is satisfied for the 7 patients. There were no...