Laparoscopically assisted colectomy and ileoanal pouch procedure with and without protective ileostomy

Kienle, Peter; Weitz, Jürgen; Benner, Axel; Herfarth, Christian; Schmidt, Jan

doi:10.1007/s00464-002-9159-1

Cited by 87 publications

(90 citation statements)

References 27 publications

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“…The possible advantages of a laparoscopic approach are a quicker recovery, potentially lower incidence of small bowel obstruction and other morbidities, and superior cosmetic results. There are now several reports assessing the feasibility and outcomes after a LIPAA in small series of patients [20,21,22,23,24]. The operation usually involves complete laparoscopic mobilization of the colon with intracorporeal vascular ligation, followed by exteriorization of the bowel through a Pfannenstiel incision.…”

Section: Ulcerative Colitismentioning

confidence: 99%

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Laparoscopic Surgery for Inflammatory Bowel Disease

Casillas

Delaney²

2005

Dig Surg

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Laparoscopic surgery has recently been gaining acceptance as an alternative approach for patients with inflammatory bowel disease. There is increasing evidence demonstrating the multiple potential benefits of laparoscopy including faster recovery, reduced costs, and lower morbidity. For patients with acute colitis, a laparoscopic subtotal colectomy and end ileostomy have been shown to be feasible and safe in experienced hands. When indicated, many of these patients may be able to safely undergo a subsequent laparoscopic approach for construction of an ileo-anal pouch. Although still controversial, an elective laparoscopic restorative proctocolectomy with ileo-anal pouch anastomosis has also been shown to be feasible with functional outcomes at least similar to those obtained with an open approach. However, larger randomized series of patients are needed with longer follow-up in order to draw definite conclusions. For Crohn’s disease, a laparoscopic approach is ideal for stoma creation. In addition, laparoscopic ileo-colectomy is arguably the preferred approach for patients with terminal ileal disease. Some experienced laparoscopic groups have also applied laparoscopic techniques for more complicated cases with recurrent disease or disease-related complications, such as fistulous disease. Other short-term benefits of a laparoscopic approach may include a decreased incidence of ventral hernias, decreased incidence of small bowel obstruction, and faster recovery. These benefits may also have significant economic impact. In contrast to earlier reports, there is reliable evidence that conversion is not associated with a poorer outcome. A policy of starting most suitable cases laparoscopically may offer patients the potential benefits of a laparoscopic approach without increasing morbidity.

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Section: Ulcerative Colitismentioning

confidence: 99%

“…The largest reported experience for LIPAA comes from the University of Heidelberg in Germany [20]. Fifty-nine patients with UC and familial adenomatous polyposis were included in a prospective cohort study.…”

Section: Ulcerative Colitismentioning

confidence: 99%

Laparoscopic Surgery for Inflammatory Bowel Disease

Casillas

Delaney²

2005

Dig Surg

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“…The technical feasibility of this approach has been shown in several series in specialized centers [28,29]. However, there is controversy in the literature on the actual benefit of minimal invasive techniques for such extensive colorectal surgery.…”

Section: Minimally Invasive Techniquesmentioning

confidence: 99%

Surgical Treatment of Severe Inflammatory Bowel Diseases

Leowardi

Heuschen²,

Kienle³

et al. 2003

Dig Dis

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Surgical treatment of severe inflammatory bowel diseases is required in failed medical treatment, in emergencies and for complications. Indications for surgery and operative techniques have changed significantly over the last few years. There is a clear tendency towards earlier and less invasive surgical interventions performed in specialized and experienced centers. Improved quality of life of patients with Crohn’s disease or ulcerative colitis after surgical therapy supports an earlier consideration of the surgical treatment option. A close cooperation with the involved gastroenterologist is mandatory in this context.

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“…Schmitt et al [28] compared duration of ileus and of hospitalization in 22 patients who underwent laparoscopic-assisted colectomy and 20 age, gender, and diagnosis-matched controls who underwent standard colectomy and they found that neither the length of time for ileus resolution nor the length of hospitalization were reduced in the laparoscopic group concluding that Lap-IPAA failed to provide any of the theoretical advantages described for other laparoscopic procedures. Other series of patients with MUC or FAP treated with laparoscopic TPC + IPAA are listed in table 1 [17,18,[29][30][31][32][33][34] .…”

Section: Laparoscopic Surgery For Ulcerative Colitis and Familial Adementioning

confidence: 99%

“…In 1976, Parks and Nicholls [15] described the technique of ileal reservoir-anal anastomosis after total proctocolectomy in 8 patients with MUC, obtaining satisfactory results in 4 out of 5 patients available to follow-up by the time of publication. During the last 30 years, restorative proctocolectomy with ileal pouchanal anastomosis (IPAA) has become the standard surgical treatment for patients with MUC and FAP [11][12][13][16][17][18][19][20][21] and several modifications to the original technique have been advocated including changes to the shape of the pouch itself [12,13] . In the original technique, a transanal mucosectomy followed by a pouch-anal hand-sewn anastomosis was performed [12,15] .…”

Section: Laparoscopic Surgery For Ulcerative Colitis and Familial Adementioning

confidence: 99%

Laparoscopic Management of Inflammatory Bowel Disease

Rosenthal¹,

Bashankaev²,

Wexner³

2009

Dig Dis

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The goal of the surgical management of Crohn’s disease is to improve quality of life. Surgical management is generally reserved for patients who developed complications of the disease or who are unresponsive to or develop complications from aggressive medical therapy. Friable mesentery, inflammatory phlegmons, fistulas, abscesses, and adhesions from previous surgeries pose a surgical challenge to the laparoscopic approach. The laparoscopic approach to terminal ileal Crohn’s disease is feasible and safe even in cases complicated by fistulas with previous abdominal surgery or recurrent disease. This approach is associated with an increased operative time compared to laparotomy, however, offers significant advantages over open ileocolic resection in terms of pulmonary function, length of hospital stay, duration of postoperative ileus, cosmesis, postoperative small bowel obstruction, and early postoperative complications. Laparoscopy is also associated with decreased overall hospitalization costs and improved patient satisfaction. Therefore, the laparoscopic approach for patients with Crohn’s disease should be considered as the preferred operative approach.

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Laparoscopically assisted colectomy and ileoanal pouch procedure with and without protective ileostomy

Cited by 87 publications

References 27 publications

Laparoscopic Surgery for Inflammatory Bowel Disease

Laparoscopic Surgery for Inflammatory Bowel Disease

Surgical Treatment of Severe Inflammatory Bowel Diseases

Laparoscopic Management of Inflammatory Bowel Disease

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