Comparative analysis between laparoscopic (UCL) and open (UCO) technique for the treatment of ulcerative colitis in pediatric patients

Abstract

Of the 165 patients with UC in our hospital, 32 underwent surgery. The laparoscopic approach seems feasible and safe. A single staged approach (Group 1 + Group 2) remains the most reasonable choice for most patients. One-step approach was done only in selected cases (Group 3). The advantages of laparoscopy, such as improved cosmetic aspects, shorter postoperative ileus and hospital stay, were observed in the laparoscopic colectomy, proctectomy and ileoanal pouch in our study.

The Role of Laparoscopic Surgery in the Management of Children and Adolescents With Inflammatory Bowel Disease

“…Over the course of the study, however, surgical times for laparoscopic procedures improved significantly and were comparable to those of open surgery. 13 This was not the patient in the largest reported series (n = 136), in which no reduction in laparoscopic operating times was observed (median time 258 minutes). 2 Linden et al reported longer operating times with a laparoscopic approach (median time 517 minutes vs 430 minutes), 14 whereas in one series no significant difference in operating time was identified between laparoscopic and open restorative proctocolectomies (mean total operating time of 443 vs 403 minutes, respectively).…”

“…A similar conversion rate was reported by Courtney et al (6.7%). 3 Even though 0% conversion rates have also been reported, 7 , 13 , 15 a rate around 7% is considered acceptable and seems comparable with the adult population (7.9%). 10 …”

“…This was suggested in one of the first series to report outcomes from laparoscopic surgery in the paediatric IBD population, including 32 children that underwent surgery for UC during an 18-year period. 13 The cohort included 25 patients who had a subtotal colectomy and end ileostomy and the outcomes of laparoscopic (n = 10) and open surgery (n = 15) were compared. The remaining 7 children had either laparoscopic (n = 3) or open (n = 4) proctectomy and ileoanal pouch or single-stage proctocolectomy and ileoanal pouch formation.…”

“… 3 , 17 Two studies have reported introduction of oral fluids in these patients after laparoscopic surgery after an average of 3 days, which compares with 6 days following an open resection. 2 , 13 In 1 cohort, clear fluids were introduced at 4 days after laparoscopic colorectal surgery and regular diet at day 5. 2 Data published from adult studies show that there is no significant difference in length of opiate use between the 2 groups.…”

“…This concurs with the data reported in the paediatric population with opiate analgesia being required for 2–3 days postoperatively in the laparoscopic group, versus up to 6 days in the open surgery group. 2 , 7 , 13 …”