Shinichi Yamauchi, MD, PhD1, Takatoshi Matsuyama, MD, PhD1, Ayumi Takaoka, MD1, Yuriko Matsumiya, MD1, Ryota Seki, MD1, Fukuichiro Orita1, Megumi Sasaki, MD1, Tomiyuki Miura, MD1, Akifumi Kikuchi, MD, PhD1, Megumi Ishiguro, MD, PhD2, Toshiaki Ishikawa, MD, PhD2, Hiroyuki Uetake, MD, PhD2, Masamichi Yasuno, MD, PhD1, Yasuaki Nakajima, MD, PhD1, Kazuyuki Kojima, MD, PhD1, Yusuke Kinugasa, MD, PhD1. 1Dept. of Surgical Gastroenterology, Tokyo Medical and Dental Univ., 2Dept. of Surgical Specialties, Tokyo Medical and Dental Univ.
Background: Recently, prevalence of ulcerative colitis (UC) continues to increase in Asian countries, including Japan. Although new strategies for UC, including anti-TNF alpha antibodies and immune-suppressants are developing, there are many patients with UC who require surgery. There are a variety of surgical technique for surgery and the use of laparoscopy for the performance of proctocolectomy (PC) is more controversial. The aim of this study is to evaluate the safety and feasibility of laparoscopic surgery for UC in a Japanese hospital.
Patients and Methods: Consecutive 60 patients with UC undergoing PC in our hospital from January 2012 to December 2017 were registered. Comparison between outcomes of laparoscopic surgery and of conventional surgery was analyzed statistically.
Results: Thirty-five patients underwent laparoscopic surgery (group L) and 25 patients underwent open surgery (group O). The median age of each groups (L and O) were 44 and 50 years old, respectively. Although the operative time was significantly longer in the group L, outcomes of the amount of blood loss and the median length of post-operative hospital stay were significantly better. Furthermore, in the group L, the rate of severe post-operative morbidities, more than grade 3 on the Clavien-Dindo classification, was significantly lower than in the group O (L: 11%, O: 21%). It remained significant after excluding more severe and emergency cases in each groups (L: 14%, O: 29%).
Conclusion: Although there are limitations that this is a retrospective study and the indication for laparoscopic or open differs from each surgeons and conditions of patients, laparoscopic PC may provide better short outcomes as some meta-analysis showed up to now.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91221
Program Number: ETP832
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster