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The use of a mini-laparotomy in total abdominal colectomy for mucosal ulcerative colitis
Tohru Nakagoe1, Terumitsu Sawai, Takashi Tsuji
1First Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. nakagoe@net.nagasaki-u.ac.jp
Background/Aims:
Minimally invasive surgery, with its advantages of early return to normal activity and good cosmetic results, is an important goal in the treatment of patients with mucosal ulcerative colitis. The aim of this study was to compare outcomes utilizing a mini-laparotomy approach to total abdominal colectomy for mucosal ulcerative colitis with those of the conventional approach.
Methodology:
Eleven patients scheduled to undergo the first (total abdominal colectomy) of a 2 or 3-stage operation for mucosal ulcerative colitis via a mini-laparotomy between 1999 and 2001 were prospectively studied. The mini-laparotomy described here involves total abdominal colectomy performed through a skin incision shorter than 7 cm. Seven similar patients who underwent conventional laparotomy between 1995 and 1998 served as the control group.
Results:
The mini-laparotomy approach was accomplished in 9 patients (81.8%). Patient characteristics between cases and controls were similar. Postoperative intervals until standing, walking, flatus, urinary catheter removal, and tolerance of solid diet were significantly shorter in the mini-laparotomy group (P = 0.031, P = 0.023, P = 0.0033, P = 0.0093, and P = 0.023, respectively).
Conclusions:
A mini-laparotomy approach to total abdominal colectomy appears feasible and safe in selected patient with mucosal ulcerative colitis and poses an attractive alternative to conventional laparotomy in patients similar to those presented here.