[Total colectomy and proctocolectomy under laparoscopic for familial adenomatous polyposis].

OBJECTIVE

To evaluate the efficacy and characteristics of treating familial adenomatous polyposis (FAP) by total colectomy and proctocolectomy under laparoscopy.

METHODS

The perioperative data, including surgical outcomes, safety, and recovery of 8 FAP patients, 5 males and 3 females, aged 39 (28 approximately 65), who underwent laparoscopic total colectomy and proctocolectomy were analyzed retrospectively and follow-up of 46.8 months (32 approximately 58 months) between April 2001 and January 2003 were analyzed and compared with the data of 6 patients undergoing conventional open surgery before 2001.

RESULTS

Laparoscopic total colectomy and proctocolectomy were performed successfully without severe complications on the 8 patients. The mean operation time of the laparoscopy group was 178 min, not significantly different from that of the conventional group (170 min, P>0.05). The mean intra-operative blood loss, anal exsufflation time, and hospital stay, and incision length of the laparoscopy group was 110 ml, 1.2 d, 12.5 d, and 0 cm, all significantly shorter than those of the conventional group (211 ml, 3.1 d, 17.4 d, and 22.3 cm, P<0.05 or P<0.01). Follow-up showed no local recurrence. The function of stool controlling was good 9 months after the operation.

CONCLUSION

With less trauma and pain, rapid recovery, and shorter hospital stay, laparoscopic total colectomy and proctocolectomy is feasible and safe for FAP. It must be performed by skilled and experienced surgeons.