Purpose: The role of laparoscopy in patient with familial adenomatous polyposis (FAP) has been controversial given its technical difficulty, high conversion rate, and complication rate. We present our experience of laparoscopic dissection and transection of rectum in the FAP patients.
Methods: Consecutive 9 patients who underwent laparoscopic surgery for FAP were recruited. Eight patients combined with carcinoma arising from FAP. All the operations were performed by the same surgeon, who had already completed the learning curve for colorectal laparoscopic procedures.
Results: Eight of the patients underwent laparoscopic total proctocolectomy (LTPC) and one patient underwent a laparoscopic total abdominal colectomy (LTAC). No hand-assisted laparoscopic technique was performed. There was no conversion case and postoperative mortality. The median operative time was 320 (range, 210-480) min, and the median blood loss was 210 (range, 50-500) ml. The median time to feeding was 2 (range, 2-3) days, and the median hospital stay was 9 (range, 7-12) days. There were two postoperative complications (small bowel obstructions). Pathology proved a carcinoma arising from FAP in eight patients and 4, 3, 1 patients had Stage I, III, IV cancers, respectively. The median number of the harvested lymph node was 116 (range, 43-204).
Conclusions: The laparoscopic approach to FAP is technically feasible and safe. It is an alternative to open surgery for surgeons experienced with the laparoscopic approach to colectomy.
Program Number: P133