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Does reduced-port laparoscopic surgery for medically uncontrolled ulcerative colitis do more harm than good?

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Title: Does reduced-port laparoscopic surgery for medically uncontrolled ulcerative colitis do more harm than good?
Other Titles: Reduced port surgery for UC
Authors: Homma, Shigenori Browse this author →KAKEN DB
Kawamata, Futoshi Browse this author
Shibasaki, Susumu Browse this author
Kawamura, Hideki Browse this author
Takahashi, Norihiko Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: laparoscopic surgery
SILS
ulcerative colitis
Issue Date: Feb-2016
Publisher: Wiley-Blackwell
Journal Title: Asian journal of endoscopic surgery
Volume: 9
Issue: 1
Start Page: 24
End Page: 31
Publisher DOI: 10.1111/ases.12250
PMID: 26490730
Abstract: Introduction: Reduced-port laparoscopic surgery is a novel minimally invasive surgery. However, reduced-port surgery for ulcerative colitis (UC) remains controversial. Here, we describe the clinical outcomes of single-incision plus one port laparoscopic surgery (SILS + 1) for medically uncontrolled UC. Methods: Between May 2011 and September 2014, 10 UC patients underwent SILS + 1 port surgery. All procedures were performed with the use of a SILS port and either a 5-mm or a 12-mm port placed at the planned ileostomy site. Results: The median age of patients was 32 years (range, 22-53 years). Six patients underwent two-stage SILS + 1 port restorative proctocolectomy with ileal pouch-anal anastomosis, two patients underwent SILS + 1 total proctocolectomy, and the remaining two patients underwent SILS + 1 subtotal colectomy with subsequent three-stage SILS + 1 ileal pouch-anal anastomosis. The median operative time was 363.1 min (range, 253-465 min) and the median estimated blood loss was 29 mL (range, 0-100 mL). There were no conversions or additional ports required. Two patients previously underwent SILS + 1 subtotal colectomy, and in one of those patients, SILS + 1 ileal pouch-anal anastomosis was performed successfully 6 months after the previous surgery. There were no intra-abdominal adhesions, and no extra wounds were necessary because the previous stoma site had been used to access the SILS port. The median postoperative period was 24 months, during which five patients had their ileostomies closed. No patients reported occasional minor daily soiling or the need to wear a pad. Conclusion: Reduced-port laparoscopic surgery for medically uncontrolled UC is a feasible and safe procedure when performed by skilled surgeons.
Rights: This is the peer reviewed version of the following article: Homma, S., Kawamata, F., Shibasaki, S., Kawamura, H., Takahashi, N. and Taketomi, A. (2016), Does reduced-port laparoscopic surgery for medically uncontrolled ulcerative colitis do more harm than good?. Asian J Endosc Surg, 9: 24–31, which has been published in final form at http://dx.doi.org/10.1111/ases.12250. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Type: article (author version)
URI: http://hdl.handle.net/2115/64443
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 川俣 太

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