Laparoscopic treatment of fulminant ulcerative colitis
The complexity and risks of the surgical treatment of ulcerative colitis are greater in patients with fulminant disease. Subtotal colectomy is frequently offered to such patients to control acute disease and restore immunological and nutritional status prior to a restorative procedure. The role of l...
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| Veröffentlicht in: | Surgical endoscopy 2002-12, Vol.16 (12), p.1778-1782 |
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| creator | BELL, R. L SEYMOUR, N. E |
| description | The complexity and risks of the surgical treatment of ulcerative colitis are greater in patients with fulminant disease. Subtotal colectomy is frequently offered to such patients to control acute disease and restore immunological and nutritional status prior to a restorative procedure. The role of laparoscopy in this setting is poorly defined.
The records of 18 patients with poorly controlled fulminant colitis on aggressive immunosuppressive therapy who underwent laparoscopic subtotal colectomy were reviewed.
Postoperative complications occurred in six patients (33%). Postoperative length of stay was 5.0 +/- 0.3 days vs 8.8 +/- 1.8 days (p |
| doi_str_mv | 10.1007/s00464-001-8300-x |
| format | Article |
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The records of 18 patients with poorly controlled fulminant colitis on aggressive immunosuppressive therapy who underwent laparoscopic subtotal colectomy were reviewed.
Postoperative complications occurred in six patients (33%). Postoperative length of stay was 5.0 +/- 0.3 days vs 8.8 +/- 1.8 days (p<0.05) for a group of six patients who had undergone open subtotal colectomy for the same indications. Systemic steroids were withdrawn in all patients, and 17 patients subsequently underwent proctectomy and pelvic pouch construction.
The relatively high morbidity rate in these patients is likely related to their compromised status at the time of surgery. Laparoscopic subtotal colectomy in patients with fulminant ulcerative colitis allows for earlier hospital discharge, facilitates subsequent pelvic pouch, construction, and provides an excellent alternative to conventional two- and three-stage surgical treatment.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-001-8300-x</identifier><identifier>PMID: 12098026</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York, NY: Springer</publisher><subject>Acute Disease ; Adolescent ; Adult ; Biological and medical sciences ; Colectomy - adverse effects ; Colectomy - methods ; Colitis, Ulcerative - surgery ; Colonic Pouches ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Postoperative Complications - epidemiology ; Stomach, duodenum, intestine, rectum, anus ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors</subject><ispartof>Surgical endoscopy, 2002-12, Vol.16 (12), p.1778-1782</ispartof><rights>2003 INIST-CNRS</rights><rights>Copyright Springer-Verlag 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-c4888d83bc91a7a0a42a1b482ffba7bb641e06089b6b47e6e02dce578ea54dce3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14442116$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12098026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BELL, R. L</creatorcontrib><creatorcontrib>SEYMOUR, N. E</creatorcontrib><title>Laparoscopic treatment of fulminant ulcerative colitis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description>The complexity and risks of the surgical treatment of ulcerative colitis are greater in patients with fulminant disease. Subtotal colectomy is frequently offered to such patients to control acute disease and restore immunological and nutritional status prior to a restorative procedure. The role of laparoscopy in this setting is poorly defined.
The records of 18 patients with poorly controlled fulminant colitis on aggressive immunosuppressive therapy who underwent laparoscopic subtotal colectomy were reviewed.
Postoperative complications occurred in six patients (33%). Postoperative length of stay was 5.0 +/- 0.3 days vs 8.8 +/- 1.8 days (p<0.05) for a group of six patients who had undergone open subtotal colectomy for the same indications. Systemic steroids were withdrawn in all patients, and 17 patients subsequently underwent proctectomy and pelvic pouch construction.
The relatively high morbidity rate in these patients is likely related to their compromised status at the time of surgery. Laparoscopic subtotal colectomy in patients with fulminant ulcerative colitis allows for earlier hospital discharge, facilitates subsequent pelvic pouch, construction, and provides an excellent alternative to conventional two- and three-stage surgical treatment.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Colectomy - adverse effects</subject><subject>Colectomy - methods</subject><subject>Colitis, Ulcerative - surgery</subject><subject>Colonic Pouches</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Semiology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BELL, R. L</creatorcontrib><creatorcontrib>SEYMOUR, N. 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L</au><au>SEYMOUR, N. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic treatment of fulminant ulcerative colitis</atitle><jtitle>Surgical endoscopy</jtitle><addtitle>Surg Endosc</addtitle><date>2002-12-01</date><risdate>2002</risdate><volume>16</volume><issue>12</issue><spage>1778</spage><epage>1782</epage><pages>1778-1782</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>The complexity and risks of the surgical treatment of ulcerative colitis are greater in patients with fulminant disease. Subtotal colectomy is frequently offered to such patients to control acute disease and restore immunological and nutritional status prior to a restorative procedure. The role of laparoscopy in this setting is poorly defined.
The records of 18 patients with poorly controlled fulminant colitis on aggressive immunosuppressive therapy who underwent laparoscopic subtotal colectomy were reviewed.
Postoperative complications occurred in six patients (33%). Postoperative length of stay was 5.0 +/- 0.3 days vs 8.8 +/- 1.8 days (p<0.05) for a group of six patients who had undergone open subtotal colectomy for the same indications. Systemic steroids were withdrawn in all patients, and 17 patients subsequently underwent proctectomy and pelvic pouch construction.
The relatively high morbidity rate in these patients is likely related to their compromised status at the time of surgery. Laparoscopic subtotal colectomy in patients with fulminant ulcerative colitis allows for earlier hospital discharge, facilitates subsequent pelvic pouch, construction, and provides an excellent alternative to conventional two- and three-stage surgical treatment.</abstract><cop>New York, NY</cop><pub>Springer</pub><pmid>12098026</pmid><doi>10.1007/s00464-001-8300-x</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adult Biological and medical sciences Colectomy - adverse effects Colectomy - methods Colitis, Ulcerative - surgery Colonic Pouches Female Gastroenterology. Liver. Pancreas. Abdomen Humans Laparoscopy - adverse effects Laparoscopy - methods Length of Stay - statistics & numerical data Male Medical sciences Middle Aged Other diseases. Semiology Postoperative Complications - epidemiology Stomach, duodenum, intestine, rectum, anus Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors |
| title | Laparoscopic treatment of fulminant ulcerative colitis |
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