Laparoscopic surgery for inflammatory bowel disease

被引:31
作者
Casillas, S
Delaney, CP
机构
[1] Cleveland Clin Fdn, Dept Colorectal Surg, Cleveland, OH 44195 USA
[2] Cleveland Clin Fdn, Minimally Invas Surg Ctr, Cleveland, OH 44195 USA
关键词
laparoscopic surgery; inflammatory bowel disease; colitis; acute; Crohn's disease;
D O I
10.1159/000087130
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 lap-aroscopic 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. Copyright (c) 2005 S. Karger AG, Basel.
引用
收藏
页码:135 / 142
页数:8
相关论文
共 42 条
[1]   Laparoscopic treatment of fulminant ulcerative colitis [J].
Bell, RL ;
Seymour, NE .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2002, 16 (12) :1778-1782
[2]   Laparoscopic ileocecal resection in Crohn's disease - A case-matched comparison with open resection [J].
Benoist, S ;
Panis, Y ;
Beaufour, A ;
Bouhnik, Y ;
Matuchansky, C ;
Valleur, P .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2003, 17 (05) :814-818
[3]   Laparoscopic versus open colorectal surgery - A randomized trial on short-term outcome [J].
Braga, M ;
Vignali, A ;
Gianotti, L ;
Zuliani, W ;
Radaelli, G ;
Gruarin, P ;
Dellabona, P ;
Di Carlo, V .
ANNALS OF SURGERY, 2002, 236 (06) :759-766
[4]   Consecutive series of laparoscopic-assisted vs. minilaparotomy restorative proctocolectomies [J].
Brown, SR ;
Eu, KW ;
Seow-Choen, F .
DISEASES OF THE COLON & RECTUM, 2001, 44 (03) :397-400
[5]   Does conversion of a laparoscopic colectomy adversely affect patient outcome? [J].
Casillas, S ;
Delaney, CP ;
Senagore, AJ ;
Brady, K ;
Fazio, VW .
DISEASES OF THE COLON & RECTUM, 2004, 47 (10) :1680-1685
[6]   Laparoscopic colectomy for benign colorectal disease is associated with a significant reduction in disability as compared with laparotomy [J].
Chen, HH ;
Wexner, SD ;
Weiss, EG ;
Nogueras, JJ ;
Alabaz, O ;
Iroatulam, AJN ;
Nessim, A ;
Joo, JS .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 1998, 12 (12) :1397-1400
[7]   Prospective, age-related analysis of surgical results, functional outcome, and quality of life after heal pouch-anal anastomosis [J].
Delaney, CP ;
Fazio, VW ;
Remzi, FH ;
Hammel, J ;
Church, JM ;
Hull, TL ;
Senagore, AJ ;
Strong, SA ;
Lavery, IC .
ANNALS OF SURGERY, 2003, 238 (02) :221-228
[8]   'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery [J].
Delaney, CP ;
Fazio, VW ;
Senagore, AJ ;
Robinson, B ;
Halverson, AL ;
Remzi, FH .
BRITISH JOURNAL OF SURGERY, 2001, 88 (11) :1533-1538
[9]   Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery [J].
Delaney, CP ;
Kiran, RP ;
Senagore, AJ ;
Brady, K ;
Fazio, VW .
ANNALS OF SURGERY, 2003, 238 (01) :67-72
[10]   Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy [J].
Duepree, HJ ;
Senagore, AJ ;
Delaney, CP ;
Fazio, VW .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2003, 197 (02) :177-181