Is laparoscopic subtotal colectomy better than open subtotal colectomy in children?

• Published in: Journal of pediatric surgery Vol. 37; no. 5; pp. 706 - 708
• Main Authors: Proctor, M.L., Langer, J.C., Gerstle, J.T., Kim, P.C.W.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.05.2002; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Child; Colectomy - methods; Colitis - surgery; Colitis, Ulcerative - surgery; Crohn Disease - surgery; Female; Humans; Ileostomy; inflammatory bowel disease; Laparoscopic colectomy; Laparoscopy - methods; Length of Stay; Male; Medical sciences; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; subtotal colectomy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Treatment Outcome; Laparoscopic colectomy; inflammatory bowel disease; subtotal colectomy; Human; Prognosis; Subtotal; Colectomy; Duration; Hospitalization; Laparoscopy; Operation; Narcotic analgesic; Inflammatory disease; Crohn disease; Surgery; Digestive diseases; Intestinal disease; Complication; Colitis; Colon; Laparotomy; Child; Comparative study; Ulcerative colitis
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1053/jpsu.2002.32258

Purpose: The role of laparoscopic colectomy is not defined clearly. The aim of this study was to compare clinical outcomes of laparoscopic versus open subtotal colectomy in children with inflammatory bowel disease. Methods: Eight consecutive patients undergoing laparoscopic subtotal colectomy were compared with 10 consecutive patients undergoing open subtotal colectomy. All patients were refractory to medical management on immunosuppressive regimens. Operating time, length of postoperative stay and intravenous narcotic use, time to return of intestinal function, and perioperative complications were compared between the groups. Results: Operating times were significantly longer in the laparoscopic group (mean laparoscopic, 4 hours 40 minutes v mean open 2 hours 25 minutes; P <.01). There was no difference between the 2 groups in length of postoperative intravenous narcotics or hospital stay. Ileostomy output occurred earlier (mean laparoscopic, 2.5 days v mean open 3.8 days; P =.01), and there was a trend toward earlier oral intake in the laparoscopic group. A total of 6 complications occurred in 4 patients in the laparoscopic group compared with 5 complications in 5 patients in the open group. Conclusions: Perioperative clinical outcomes, including complication rates, are similar with laparoscopic and open subtotal colectomy. Laparoscopic subtotal colectomy can be performed safely in children with improved cosmesis. J Pediatr Surg 37:706-708. Copyright 2002, Elsevier Science (USA). All rights reserved.