Abstract
Laparoscopic total abdominal colectomy has an established role in the treatment of inflammatory bowel disease and other benign conditions as well as synchronous neoplasms and/or hereditary colorectal cancer syndromes. There are well documented short- and long‑term benefits of laparoscopy which include reduced pain, bleeding, length of stay, and decrease in abdominal adhesions for subsequent operations. Laparoscopic total abdominal colectomy with end-ileostomy and defunctionalized rectosigmoid stump has become the most common initial operation for ulcerative colitis. Massive bleeding, colonic perforation and megacolon were traditionally an absolute contraindication to laparoscopy. However, as the technological advancement and surgical experience with laparoscopy have improved, both are considered a relative contraindication dependent on the specific circumstances. Direct laparoscopic manipulation of the colon should be minimized, particularly in the urgent setting, and laparoscopic ligation of the lymphovascular pedicles at their origin and complete mesocolic excision is required when the possibility of malignancy is a concern. With the clear benefits of laparoscopic total colectomy, it is in the best interest of the patient to perform these procedures laparoscopically, even in the emergent setting, if the surgeon deems it safe.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Keller DS, Pedraza R, Flores-Gonzalez JR, LeFave JP, Mahmood A, Haas EM. The current status of emergent laparoscopic colectomy: a population-based study of clinical and financial outcomes. Surg Endosc. 2016;30(8):3321–6.
Sujatha-Bhaskar S, Alizadeh RF, Koh C, Inaba C, Jafari MD, Carmichael JC, et al. The growing utilization of laparoscopy in emergent colonic disease. Am Surg. 2017;83(10):1068–73.
Geltzeiler CB, Lu KC, Diggs BS, Deveney KE, Keyashian K, Herzig DO, et al. Initial surgical management of ulcerative colitis in the biologic era. Dis Colon Rectum. 2014;57(12):1358–63.
Bikhchandani J, Polites SF, Wagie AE, Habermann EB, Cima RR. National trends of 3- versus 2-stage restorative proctocolectomy for chronic ulcerative colitis. Dis Colon Rectum. 2015;58(2):199–204.
Causey MW, Stoddard D, Johnson EK, Maykel JA, Martin MJ, Rivadeneira D, et al. Laparoscopy impacts outcomes favorably following colectomy for ulcerative colitis: a critical analysis of the ACS-NSQIP database. Surg Endosc. 2013;27(2):603–9.
Ritter KA, Burke JP, Stocchi L, Aiello A, Holubar S, Ashburn JH, et al. Postoperative steroid taper is associated with pelvic sepsis after ileal pouch-anal anastomosis. Inflamm Bowel Dis. 2019; 25(8):1383–9.
Zittan E, Wong-Chong N, Ma GW, McLeod RS, Silverberg MS, Cohen Z. Modified two-stage ileal pouch-anal anastomosis results in lower rate of anastomotic leak compared with traditional two-stage surgery for ulcerative colitis. J Crohns Colitis. 2016;10(7):766–72.
Kulaylat AS, Kulaylat AN, Schaefer EW, Tinsley A, Williams E, Koltun W, et al. Association of preoperative anti-tumor necrosis factor therapy with adverse postoperative outcomes in patients undergoing abdominal surgery for ulcerative colitis. JAMA Surg. 2017;152(8):e171538.
Selvasekar CR, Cima RR, Larson DW, Dozois EJ, Harrington JR, Harmsen WS, et al. Effect of infliximab on short-term complications in patients undergoing operation for chronic ulcerative colitis. J Am Coll Surg. 2007;204(5):956–62; discussion 62–3.
Mor IJ, Vogel JD, da Luz Moreira A, Shen B, Hammel J, Remzi FH. Infliximab in ulcerative colitis is associated with an increased risk of postoperative complications after restorative proctocolectomy. Dis Colon Rectum. 2008;51(8):1202–7; discussion 7–10.
Gu J, Remzi FH, Shen B, Vogel JD, Kiran RP. Operative strategy modifies risk of pouch-related outcomes in patients with ulcerative colitis on preoperative anti-tumor necrosis factor-alpha therapy. Dis Colon Rectum. 2013;56(11):1243–52.
Wu JS, Paul P, McGannon EA, Church JM. APC genotype, polyp number, and surgical options in familial adenomatous polyposis. Ann Surg. 1998;227(1):57–62.
Ooi BS, Remzi FH, Fazio VW. Turnbull-Blowhole colostomy for toxic ulcerative colitis in pregnancy: report of two cases. Dis Colon Rectum. 2003;46(1):111–5.
Gu J, Stocchi L, Remzi F, Kiran RP. Intraperitoneal or subcutaneous: does location of the (colo)rectal stump influence outcomes after laparoscopic total abdominal colectomy for ulcerative colitis? Dis Colon Rectum. 2013;56(5):615–21.
Salinas H, Dursun A, Konstantinidis I, Nguyen D, Shellito P, Hodin R, et al. Does preoperative total parenteral nutrition in patients with ulcerative colitis produce better outcomes? Int J Colorectal Dis. 2012;27(11):1479–83.
Alves-Ferreira PC, de Campos-Lobato LF, Zutshi M, Hull T, Gurland B. Total abdominal colectomy has a similar short-term outcome profile regardless of indication: data from the National Surgical Quality Improvement Program. Am Surg. 2011;77(12):1613–8.
Onder A, Benlice C, Church J, Kessler H, Gorgun E. Short-term outcomes of laparoscopic versus open total colectomy with ileorectal anastomosis: a case-matched analysis from a nationwide database. Tech Coloproctol. 2016;20(11):767–73.
Reshef A, Gurland B, Zutshi M, Kiran RP, Hull T. Colectomy with ileorectal anastomosis has a worse 30-day outcome when performed for colonic inertia than for a neoplastic indication. Colorectal Dis. 2013;15(4):481–6.
Bartels SA, Gardenbroek TJ, Ubbink DT, Buskens CJ, Tanis PJ, Bemelman WA. Systematic review and meta-analysis of laparoscopic versus open colectomy with end ileostomy for non-toxic colitis. Br J Surg. 2013;100(6):726–33.
Tillou J, Poylin V. Functional disorders: slow-transit constipation. Clin Colon Rectal Surg. 2017;30(1):76–86.
Khan M, Jayne D, Saunders R. Comparison of defecatory function after laparoscopic total colectomy and ileorectal anastomosis versus a traditional open approach. Ann R Coll Surg Engl. 2018;100(3):235–9.
Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Pigazzi A, Stamos MJ, Mills S. Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy. Surg Endosc. 2016;30(7):2792–8.
Ouaissi M, Lefevre JH, Bretagnol F, Alves A, Valleur P, Panis Y. Laparoscopic 3-step restorative proctocolectomy: comparative study with open approach in 45 patients. Surg Laparosc Endosc Percutan Tech. 2008;18(4):357–62.
Chung TP, Fleshman JW, Birnbaum EH, Hunt SR, Dietz DW, Read TE, et al. Laparoscopic vs. open total abdominal colectomy for severe colitis: impact on recovery and subsequent completion restorative proctectomy. Dis Colon Rectum. 2009;52(1):4–10.
Watanabe K, Funayama Y, Fukushima K, Shibata C, Takahashi K, Sasaki I. Hand-assisted laparoscopic vs. open subtotal colectomy for severe ulcerative colitis. Dis Colon Rectum. 2009;52(4):640–5.
Telem DA, Vine AJ, Swain G, Divino CM, Salky B, Greenstein AJ, et al. Laparoscopic subtotal colectomy for medically refractory ulcerative colitis: the time has come. Surg Endosc. 2010;24(7):1616–20.
Bartels SA, Vlug MS, Henneman D, Ponsioen CY, Tanis PJ, Bemelman WA. Less adhesiolysis and hernia repair during completion proctocolectomy after laparoscopic emergency colectomy for ulcerative colitis. Surg Endosc. 2012;26(2):368–73.
Parnaby CN, Ramsay G, Macleod CS, Hope NR, Jansen JO, McAdam TK. Complications after laparoscopic and open subtotal colectomy for inflammatory colitis: a case-matched comparison. Colorectal Dis. 2013;15(11):1399–405.
Frid NL, Bulut O, Pachler J. Acceptable short-term outcome of laparoscopic subtotal colectomy for inflammatory bowel disease. Dan Med J. 2013;60(6):A4645.
Gu J, Stocchi L, Remzi FH, Kiran RP. Total abdominal colectomy for severe ulcerative colitis: does the laparoscopic approach really have benefit? Surg Endosc. 2014;28(2):617–25.
Messenger DE, Mihailovic D, MacRae HM, O'Connor BI, Victor JC, McLeod RS. Subtotal colectomy in severe ulcerative and Crohn’s colitis: what benefit does the laparoscopic approach confer? Dis Colon Rectum. 2014;57(12):1349–57.
Buchs NC, Bloemendaal ALA, Wood CPJ, Travis S, Mortensen NJ, Guy RJ, et al. Subtotal colectomy for ulcerative colitis: lessons learned from a tertiary centre. Colorectal Dis. 2017;19(5):O153–o61.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
About this chapter
Cite this chapter
Costedio, M., Stocchi, L. (2020). Laparoscopic Total Abdominal Colectomy for Emergent and Elective Indications: Perioperative Considerations and Techniques. In: Sylla, P., Kaiser, A., Popowich, D. (eds) The SAGES Manual of Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-24812-3_34
Download citation
DOI: https://doi.org/10.1007/978-3-030-24812-3_34
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-24811-6
Online ISBN: 978-3-030-24812-3
eBook Packages: MedicineMedicine (R0)