Total Proctocolectomy in Ulcerative Colitis: Laparotomy Vs Laparoscopy - A Systematic Review

• Autor(a) principal: Maria Catarina Leonardo Fernandes de Viveiros
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/142058
• topic: Medicina clínica; Clinical medicine

Introduction: Ulcerative Colitis is a chronic inflammatory bowel disease affecting the rectum and extending proximally. Some patients remain asymptomatic, while others require surgical intervention. Currently, total proctocolectomy with an ileal pouch-anal anastomosis is accepted as the gold standard for the surgical treatment. Open or laparoscopic approach is still remaining controversial. Aim: The aim of this systematic review is to determine whether the outcomes following laparoscopic approach are superior to the open approach in Ulcerative Colitis patients. Methods: This systematic review was carried out between August and September 2021 on Pubmed and Scopus using the query "total proctocolectomy" AND "ulcerative colitis" AND (laparoscop* or (laparotom* or open)). Results: Fifteen articles were included in this review. There was no significant difference between groups concerning amount of blood loss, small bowel obstruction, anastomotic leakage, wound disruption and infection, pouchitis, systemic sepsis, fecal incontinence and recovery of bowel movement. Laparoscopy was superior regarding number of blood transfusions, intestinal perforation and length of hospital stay. Concerning operative time, open approach showed a better outcome. Conclusion: Laparoscopic approach is a safe treatment for these patients. Multicenter and prospective studies comparing both approaches are needed to clarify controversial outcomes.