Comparision Of The Clinical Efficacy Of Laparoscopic Total Colectomy And Open Surgery For Familial Adenmatous Polyposis

Objective:With the more mature of laparoscopic technology, the accumulation of clinical experience and the innovation of the surgical instrument, laparoscopic surgery shows small trauma, rapid recovery compared with open surgery and advantages gradually recognized, that make the application of laparoscopic surgery more extensive. This study by comparing laparoscopic total colectomy with traditional open surgery for the treatment of familial adenomatous poryposis clinical curative effect, discusses the safety, feasibility and the clinical application value.Methods:We retrospectively analyzed clinical data of 37 patients with FAP in our department from January 2009 to October 2014.It shows that 19 cases of laparoscopic total colectomy (laparoscopic group) and 18 ceses of traditional open surgery (open group). Through SPSS 21.0 statistical software deal with preoperative, intraoperative and postoperative data to analysis the clinical effect of laparoscopic surgery compared with the traditional open operation, and combining with some literatures discussed and evaluated.Rescult:Both lapascopic group and open group were successfully completed surgery, and have no one case was converted to open surgery. The two groups had no significant variances in gender, age, body mass index, family history of FAP, polyp canceration, preoperative anemia, ASA classification(P>0.05). Laparoscopic group compared with open group had shorter incision (5.8±0.7cm VS 19.9±1.6 cm) and less intraoperative blood loss(137.9±30.1 ml VS 188.9±53.8 ml),and these differences between the two groups have significant statistical significance (P<0.01). Laparoscopic group compared with the traditional laparotomy surgery operating time is extended(277.8±35.9 min VS 237.8±26.9 min), and a significant difference between the two groups have statistical significance (P<0.01).The numbers of intraoperative blood transfusion were no significance between the two groups (P>0.05). Laparoscopic group have an obviously advantage in postoperative recovery such as the time of gastrointestinal function recovery, urine tube pulling up and eating liquid and the use of analgesic drugs,3 days of abdominal cavity flow than open group (P<0.05), especially in the time of postoperative activity, eating semiliquid and hospital stay(P<0.01). Both lapascopic group and open group have appeared the situation of the anastomotic fistula, but the rate of postoperative complications was no statistically significant difference (21.1% VS 27.8% P>0.05).And there was no significance of follow-up time, follow-up rate, metastasis rate and mortality between the two groups after operation (P>0.05).Conclusions:Laparoscopic total colectomy for FAP has the the advantages of smaller trauma, less intraoperative blood loss, less pain,rapid postoperative recovery and shorter hospital stay than traditional open surgery.And there was no significance of postoperative complications rate, metastasis rate and mortality between the two groups after operation. It’s safe, feasible and has a good applied future in the clinical practice for FAP.