Laparoscopic subtotal colectomy for acute or severe colitis complicating inflammatory bowel disease: A case-matched study in 88 patients

Pre‐operative management is associated with low rate of post‐operative morbidity in penetrating Crohn’s disease

“…Poor nutritional state and low serum albumin certainly increase post-operative morbidity and the risk of a twostage procedure. 7,19,20 Pre-operative nutritional therapies can improve nutritional parameters and wound healing even before nutritional parameters show any change. 21,22 Recent calorie intake may be more important than nutritional status.…”

Laparoscopic total colectomy: Does the indication influence the outcome?

“…Both patients with Crohn's disease suffered anastomotic leaks although one had a defunctioning stoma. Several studies report high morbidity rates (up to 35%), with a conversion rate reaching 30% for laparoscopic surgery in Crohn's disease [3,8,[16][17][18] . In our opinion, all patients with Crohn's disease who undergo total colectomy should be prepared for a defunctioning stoma.…”

Laparoscopic Surgery for Severe Ulcerative Colitis

“…Several studies have reported the feasibility and safety of laparoscopic assisted total colectomy for ulcerative colitis in the elective setting, and shown the advantages of laparoscopic assisted total colectomy such as reduced postoperative pain, earlier return of intestinal function, decreased length of hospital stay, and improved cosmesis (Marcello et al, 2000;Hashimoto et al, 2001;Seshadri et al, 2001;Gill et al, 2004;Kienle et al, 2005;Larson et al, 2005). On the basis of these results, several studies have evaluated the feasibility and safety of minimally invasive surgery for selected patients with severe ulcerative colitis (Dunker et al, 2000;Bell & Seymour, 2002;Marceau et al, 2007;Fowkes et al, 2008;Watanabe et al, 2009;Holubar et al, 2009;Chung et al, 2009;Maggiori et al, 2010;Telem et al, 2010). These retrospective trials indicated that minimally invasive subtotal colectomy for selected patients with severe ulcerative colitis associated with a marked reduction in wound complication rate, time to return of bowel function, and mean hospital stay, although most of these studies have reported that the mean operating time was longer than open surgery.…”

“…With a mean delay of 80 ± 20 days (range: 43 to 129 days), intestinal continuity was restored in 100 percent of the cases. Fowkes et al (Fowkes et al, 2008) (Marceau et al, 2007) from Beaujon Hospital, France conducted a casematched study to assess the feasibility and safety of laparoscopic-assisted subtotal colectomy (n=40) (Ulcerative colitis, n=14; Crohn's disease, n=29; Indeterminate colitis, n=5) compared with open subtotal colectomy (n=48) (Ulcerative colitis, n=26; Crohn's disease, n=13; Indeterminate colitis, n=1) in patients with severe colitis. Two (5%) patients required conversion to open surgery because of intensive adhesions (n=1) and colonic fistula (n=1).…”