| Autor: |
UMEMOTO, Takahiro, KIJIMA, Kazuhiro, SATO, Sumito, YATSUOKA, Toshimasa, KATO, Takashi, TANAKA, Jun-ichi |
| Jazyk: |
angličtina |
| Rok vydání: |
2015 |
| Zdroj: |
The Showa University journal of medical sciences. 27(4):291-296 |
| ISSN: |
0915-6380 |
| Popis: |
We report the case of a 40-year-old woman with refractory ulcerative colitis (UC) whose condition did not improve despite aggressive medical therapy with a corticosteroid and an immunosuppressor. The patient underwent a total proctocolectomy by reduced port surgery (RPS). A vertical incision of 30mm was made through the umbilicus, and a laparoscope port and two working or assistant laparoscopic ports were inserted through the fascia. A 5mm port was used as the terminal ileostomy site and another 5mm port was used as a drain site (marked preoperatively). The operator used a standard laparoscopic 5mm atraumatic grasper for the left hand and a standard laparoscopic dissector or an Enseal energy device for the right hand. An ileal J-pouch was created extra-corporeally from the terminal ileum and then an ileal pouch–anal anastomosis (IPAA) was created by hand suturing. The diverting loop ileostomy was brought out through the right iliac fossa, and there was 30cm of ileum between the diverting loop ileostomy and the IPAA. The surgical procedures were very similar to those normally used in laparoscopic colectomy. The duration of the surgery was 465min, and blood loss was estimated at 240ml. No intraoperative complications occurred, and conversion to conventional laparoscopic or open surgery was not needed. Laparoscopic total proctocolectomy using RPS (compared with standard laparoscopic surgery) may be preferred for young women because it reduces the wound size, minimizes postoperative pain, and enhances cosmesis. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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