Alternative specimen extraction techniques after laparoscopic emergency colectomy in inflammatory bowel disease.

Abstract

BACKGROUND:

Omitting the extraction site incision potentially further decreases the abdominal wall trauma in laparoscopic surgery. The purpose of this study was to report the results of alternative specimen extraction techniques after laparoscopic emergency colectomy in patients with inflammatory bowel disease (IBD).

METHODS:

Ten consecutive patients with IBD underwent (sub)acute emergency colectomy for refractory disease from October 2009 until December 2010. The specimen was retrieved via the stoma site in three and transrectally in seven patients. Patient data were prospectively collected. In case of later completion proctectomy and pouch procedure, adhesions were systematically scored.

RESULTS:

The extraction techniques were all feasible. Median operative time was 219 (interquartile range (IQR), 197-232) min. The pain scores and morphine requirement in patients decreased quickly after surgery. No infectious complications occurred. In five patients, a completion proctectomy was performed at a median time of 7 (IQR, 3.8-9.3) months after colectomy. All patients showed absence of any adhesions in the pelvis. In two patients, limited adhesions of the cut side of the mesentery were present.

CONCLUSIONS:

Specimen extraction via the rectum or stoma site is a safe, alternative way to extract the specimen after laparoscopic colectomy. No infectious complications were observed postoperatively and no pelvic adhesions were found during completion proctectomy.

• Authors: Tjibbe J Gardenbroek, Emma J Eshuis, Gijs J D van Acker, Pieter J Tanis, Willem A Bemelman
• Journal: Surgical endoscopy (Surg Endosc) Vol. 26 Issue 2 Pg. 408-12 (Feb 2012) ISSN: 1432-2218 [Electronic] Germany
• PMID: 21909858 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Morphine

Topics

• Adolescent
• Adult
• Analgesics, Opioid (therapeutic use)
• Colectomy (methods)
• Colonic Pouches
• Emergencies
• Emergency Treatment (methods)
• Female
• Humans
• Inflammatory Bowel Diseases (surgery)
• Laparoscopy (methods)
• Male
• Morphine (therapeutic use)
• Pain, Postoperative (etiology, prevention & control)
• Proctocolectomy, Restorative (methods)
• Prospective Studies
• Reoperation
• Specimen Handling (methods)
• Tissue Adhesions (etiology)
• Treatment Outcome
• Young Adult