Single incision laparoscopic (SILS) restorative proctocolectomy with ileal pouch-anal anastomosis
| Autor: | A. C. Goede, K. J. Gash, Anthony R Dixon, B. Kaldowski, B. Vestweber |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Colonic Pouches Young Adult Single port surgery medicine Humans Prospective Studies Postoperative Care business.industry Proctocolectomy General surgery Proctocolectomy Restorative Length of Stay Middle Aged medicine.disease Ulcerative colitis Ileal Pouch Anal Anastomosis Single incision laparoscopic Treatment Outcome Colitis Ulcerative Female Laparoscopy Surgery Ileoanal pouch business Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 25:3877-3880 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-011-1814-y |
| Popis: | Restorative proctocolectomy with ileoanal pouch is the definitive procedure in ulcerative colitis. The potential benefits afforded by a single incision laparoscopic (SILS) approach make it appropriate to consider.Electronic data were prospectively collected from all patients who underwent SILS restorative proctocolectomy (SILS-RPC) between June 2009 and June 2010.Ten consecutive patients (4 male), with median BMI = 22 (range = 20-28 kg/m(2)) underwent SILS-LRPC over a 1-year period. Three had undergone a previous emergency laparoscopic colectomy. A single-port device (Covidien SILS™ or Olympus TriPort™) was positioned at the site of the existing or proposed temporary ileostomy (2.5-cm incision). The colon and rectum were extracted through the SILS site (n = 8) or transanally following a mucosectomy (n = 2). A 20-cm J pouch was constructed extracorporeally and returned via the ileostomy site. Pouch-anal anastomosis was performed intracorporeally (n = 8) or hand-sutured (n = 2) and a diverting loop ileostomy was created at the SILS port site. The median operation time was 185 min (range = 100-381). There were no conversions or additional ports required. Median time to full diet was 36 h (range = 4-48 h) with a median hospital stay of 3 days (range = 2-8 days). There were no 30-day readmissions. Complications included surgical emphysema with temperature and a panic attack. Nine stomas have been closed. All patients have spontaneity of defecation, with a median pouch frequency of four per day, including once at night. All are fully continent and able to defer during the day. One reported a dry ejaculate for 10 weeks.SILS restorative proctocolectomy is safe with good early functional outcomes when performed by an experienced laparoscopic surgeon. |
| Databáze: | OpenAIRE |
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