Gill TS, Karantana A, Rees J, Pandey S, Dixon AR.

Department Colorectal Surgery, North Bristol NHS Trust, Frenchay
Hospital, Bristol BS16 1LE, UK.

OBJECTIVE: The aim of the study was to analyse the outcome of
restorative proctocolectomy carried out by laparoscopic surgery.
METHODS: A prospectively collected electronic database of all
colorectal laparoscopic procedures performed between April 2001 and
July 2003 has been used to identify surgical outcomes in 14 consecutive
patients who have undergone laparoscopic RPC. RESULTS: Fourteen
patients (5 male), median BMI 24 kg/m(2) have undergone restorative
laparoscopic proctocolectomy over a two year period: 13 (ulcerative
colitis, one with cancer) and 1 (FAP). The median operation time was
260 min; time has not decreased with experience. There were no
intra-operative surgical complications or deaths. Patient controlled
analgesia continued for a median of 36 h. The median time to diet was
48 h and median hospital stay 7 days; three patients required
nasogastric aspiration for delayed gastric emptying. Eighteen regional
lymph nodes were retrieved local to the carcinoma. There was one
anastomotic leak. All covering stomas were closed by 6 months (12 by
eight weeks). All 14 patients are fully continent, able to suppress
urgency and have a median pouch frequency of 4/24 h. None admit to
having problems with potency, orgasm sensation, ejaculation,
micturition. One lady reports dysparunia. All are highly satisfied with
functional outcome and cosmesis. CONCLUSION: We are encouraged to
continue to offer our patients the option of a laparoscopic resection.