Surgical Outcome After Laparoscopic Surgery in Patients With Colonic Adenomatous Polyposis Syndromes

Francisco Lopez-kostner, MD, Alejandro J Zarate, MD, Udo Kronberg, MD, Claudio Wainstein, MD, Katya Carrillo, MD. Colorectal Unit. Clinica las Condes


Introduction: Colonic adenomatous poliposis (CAP) syndromes include classical FAP and attenuated polyposis and are associated to a higher risk to develop colorectal cancer. Surgical treatment includes complete removal of the colon and sometimes the rectum followed by ileorectal anastomosis or ileoanal pouch anastomosis, respectively. Laparoscopic surgery is a standard procedure in partial colectomy; however few publications have analyzed its role in colonic adenomatous polyposis.
Objective: To analyze surgical outcomes in patients with CAP who underwent laparoscopic total colectomy followed by IRA and restorative proctocolectomy.
Patients and methods: From the prospective laparoscopic colorectal surgery database (2002-2011) patients with diagnosis of CAP were included. Demographic clinical data was analyzed such as type of surgery, operating time, time to oral feeding, complications and length of hospital stay.
Results: Thirty-eight patients were included, 17 of the female with an average age of 40.2 years. A total of 25 total colectomies with ileorectal anastomosis were performed (TC), 11 proctocolectomies with ileal-pouch anal anastomosis (IPAA) and 2 proctectomies with ileal-pouch (PT). Mean operating time was 249, 324 y 235 minutes for TC, IPAA and PT groups, respectively. Mean time to oral feeding was 2.5, 2.6 and 2 days for TC, IPAA and PT groups, respectively. Postoperative surgical complications occurred in 6, 2 y 1 for patients in TC, IPAA and PT groups, respectively. The mean length of hospital stay was 6.4, 6.9 and 15 days, for TC, IPAA and PT groups, respectively.
In summary, surgery for FAP and attenuated FAP is feasible by laparoscopic approach, with early oral feeding and less than a week of total hospital stay.

Session Number: Poster – Poster Presentations
Program Number: P105
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