Laparoscopy-assisted total/subtotal colectomy: a report of 150 cases

Abstract

To summarize the clinical experience and to evaluate the safety and technical characters of laparoscopy-assisted total/subtotal colectomy(LAC). From June 2005 to May 2008, a total of 150 cases underwent LAC in Jinling Hospital. There were 126 cases of severe functional constipation (SFC) treated by LAC combined with modified Duhamel procedure. There were 11 cases of familial adenomatous polyposis, 8 cases of ulcer colitis and 5 cases of multiple colorectal tumors treated with LAC combined with ileum-rectum anastomosis. Of the 150 cases, LAC was successfully performed in 147 cases. The mean operation time of LAC was (76.0+/-23.5) min. The estimated operative blood loss was (35.4+/-10.9) ml. The length of assisted incision was (5.2+/-1.1) cm. The time to resume intestinal function was (42.5+/-12.6) h. There was no postoperative wound infection, anastomotic stoma and other complications. Within 1 week after operation, severe diarrhea occurred in 2 cases and incomplete small bowl obstruction in 2 cases, who were relieved by conservative treatment. The mean postoperative hospital stay in patients without complication was(7.2+/-1.5) d. One year later, the score of gastrointestinal index quality of life in 116 patients was (110.3+/-20.7), which was significantly elevated as compared with the pre-operation score (90.1+/-23.8) and was not significantly different with the healthy score. The constipation symptoms were released in all the 105 SFC patients with different degree diarrhea in 7 cases and recurrence of mild constipation in 4 cases. There was no sign of recurrence and metastasis in 3 cases of multiple colorectal tumors. LAC embodies the advantages of less invasiveness of laparoscopy. It is a reasonable choice of operation method in treating various diseases related to total colon.