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International Journal of Colorectal Disease

, Volume 25, Issue 8, pp 949–957 | Cite as

The role of laparoscopic surgery for ulcerative colitis: systematic review with meta-analysis

  • Xiao-Jian Wu
  • Xiao-Sheng He
  • Xu-Yu Zhou
  • Jia Ke
  • Ping LanEmail author
Original Article

Abstract

Purpose

Crohn’s disease is established in laparoscopic surgery due to partial bowel dissection and low postoperative complication rate. However, laparoscopic surgery for ulcerative colitis remains further discussed even if the trend of minimally invasive technique exists. This study is to figure out how laparoscopic surgery works for ulcerative colitis.

Methods

Sixteen controlled trials were identified through the search strategy mentioned below. There was only one prospective randomized study among the studies selected. A meta-analysis pooled the outcome effects of laparoscopic surgery and open surgery was performed. Fixed effect model or random effect model was respectively used depending on the heterogeneity test of trials.

Results

Postoperative fasting time and postoperative hospital stay were shorter in laparoscopic surgery for ulcerative colitis (−1.37 [−2.15, −0.58], −3.22 [−4.20, −2.24], respectively, P < 0.05). Overall complication rate was higher in open surgery, compared with laparoscopic surgery (54.8% versus 39.3%, P = 0.004). However, duration of laparoscopic surgery for ulcerative colitis was extended compared with open surgery (weighted mean difference 69.29 min, P = 0.04). As to recovery of bowel function, peritoneal abscess, anastomotic leakage, postoperative bowel obstruction, wound infection, blood loss, and mortality, laparoscopic surgery did not show any superiority over open surgery. Re-operation rate was almost even (5.2% versus 7.3%). The whole conversion to open surgery was 4.2%.

Conclusions

Laparoscopic surgery for ulcerative colitis was at least as safe as open surgery, even better in postoperative fasting time, postoperative hospital stay, and overall complication rate. However, clinical value of laparoscopic surgery for ulcerative colitis needed further evaluation with more well-designed and long-term follow-up studies.

Keywords

Ulcerative colitis Laparoscopic surgery Open surgery Systematic review 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Xiao-Jian Wu
    • 1
  • Xiao-Sheng He
    • 1
  • Xu-Yu Zhou
    • 2
  • Jia Ke
    • 1
  • Ping Lan
    • 1
    Email author
  1. 1.Department of Colorectal Surgery, The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouChina
  2. 2.Medical Information Research InstituteSun Yat-sen UniversityGuangzhouChina

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