Revista chilena de cirugía
versión On-line ISSN 0718-4026
PINEDO M, GEORGE. Laparoscopic total colectomy for colonia inertia: Immediate and late results. Rev Chil Cir [online]. 2008, vol.60, n.5, pp. 410-417. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262008000500008.
Background: Total colectomy with Neo-recto anastomosis has the best results in the treatment of colonic inertia but it is a complex procedure. Laparoscopic approach is a less invasive alternative. Aim: To report the results of laparoscopic total colectomy with Neo rectal anastomosis for the treatment of colonic inertia. Material and Methods: Review of medical records of patients with colonic inertia subjected to a laparoscopic total colectomy with Neo rectal anastomosis. All had a complete preoperative study for constipation. A telephonefollow up was performed asking for constipation, fecal incontinence and iftheywould recommend the procedure to other patients. Results: Twenty female patients aged 18 to 52 years were operated. Mean operative time was 248 minutes. In 5% of patients, conversión to open surgery was required. The lapse for gas expulsión and resumption of oral feeding was two and three days after surgery, respectively. Mean hospital stay was seven days. Seven patients (35%) has complications (a postoperative ileus in three, a portal vein thrombosis in one, hematochezia in one and hemoperitoneum that required a new laparoscopy in one). The Wexler score for constipation was 22.3 (range 19-29) in the preoperative period and decreased to 1.8 (range 0-6) in the telephone follow up. The mean level of satisfaction was 8 (range 2-10) and only one patient would not recommend the procedure to other patients. Conclusions: Laparoscopic total colectomy for colonic inertia has a 35% rate of complications in immediate postoperative period and good functional results in the long term follow up.
Palabras llave : Laparoscopic colectomy; constipation; colonic inertia.