Minimally invasive total proctocolectomy with Brooke ileostomy for ulcerative colitis

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Total proctocolectomy with Brooke ileostomy is standard for select ulcerative colitis patients.
• Limited data exists on minimally invasive approaches for this procedure.
• This study evaluates short-term outcomes of minimally invasive total proctocolectomy with Brooke ileostomy.

Purpose of the Study:

• To assess the safety and feasibility of minimally invasive total proctocolectomy with Brooke ileostomy.
• To report short-term (30-day) outcomes.
• To identify patient characteristics and indications for the procedure.

Main Methods:

• Prospective database analysis of patients undergoing laparoscopic total proctocolectomy with Brooke ileostomy (2000-2007).
• Data collection on patient demographics, surgical approach, operative time, length of stay, and complications.
• Reporting of results as median (range) or frequency (proportion).

Main Results:

• 44 patients included; indications were refractory colitis (82%) and neoplasia (18%).
• Minimally invasive approaches included hand-assisted, laparoscopic-assisted, and laparoscopic-incisionless techniques.
• Major post-operative complications occurred in 9% of patients, with no perioperative mortalities.

Conclusions:

• Minimally invasive total proctocolectomy with Brooke ileostomy is a safe and feasible surgical option.
• This approach is suitable for select patients with chronic ulcerative colitis.
• The procedure demonstrates favorable short-term outcomes.