. Laparoscopic total colectomy with ileo-rectal anastomosis for polyposis and ulcerative colitis.

Objective of the study: Since the introduction of laparoscopic colorectal surgery, several studies have demonstrated the advantages of mini-invasive segmental colon resections in the treatment of benign and malignant diseases. On the contrary the use of laparoscopy for total colectomy and proctocolectomy is not worldwide accepted first of all because of the technically challenging nature of these procedures. The aim of this report is to show the feasibility and safety of straight laparoscopic total colectomy (LTC) for polyposis (P) and ulcerative colitis (UC).Material and methods: Between January 2006 and June 2007 in our Institution 5 patients underwent to LTC with ileorectal anastomosis plus temporary loop ileostomy for P ( 2 cases) and UC (3 cases). Results: The mean age was 69.2 yrs (62-77) and in all cases the preoperative endoscopy showed the distal rectum almost without signs of disease. Mean operative time was 320 minutes and the estimated mean blood loss was 250 cc. No transfusions were necessary. No conversions occurred. The mean surgical specimen length was 100 cm. and in all acses the margins of resection were disease free. Considering the postoperative course, no morbidity and mortality occurred. The mean hospital stay was 8 days. The temporary ileostomy was suppressed in all patients within three months since the procedure. Conclusions: The analysis of our data highlights that LTC is effective and feasible even if the use of this procedure, because of its complexity, has to be reserved to well-trained laparoscopic surgeons.