Surgical Outcomes of Laparoscopic Colorectal Resections for Familial Adenomatous Polyposis

Abstract

Laparoscopic TPC and TAC represent an interesting alternative approach for young and motivated familial adenomatous polyposis patients. When performed by experienced surgeons, they provide excellent short-term outcome regarding immediate recovery, morbidity, and cosmesis.

Risk factors for prolonged length of stay after colorectal surgery

“…However, we believe these possible differences would not be signifi cant enough to infl uence the operative results, as there are no major difference in postoperative results from Brazilian institutions when compared to those from US hospitals. [11][12][13][14][15][16][17][18][19] Another limitation is related to defi nition of prolonged LOS used in this study. Although one could consider it arbitrary, there is no standard defi nition available in the literature and we believe that defi ning prolonged LOS as a LOS within the 4 th quartile for LOS makes clinical and statistical sense.…”

Current trends regarding protective ileostomy after restorative proctocolectomy

“…In our own series, one patient submitted to a one-stage procedure developed a postoperative fi stula successfully treated with intestinal deviation. 21 So far, we have preferred to perform laparoscopic RPC with ileostomy, and this choice is also based on the potential risk of desmoid tumors in FAP, which has been associated with surgical trauma among other predictive factors.…”

Colorectal polyposis: clinical presentation and surgical treatment

“…Consequently, patients have better bowel function, quality of life, sexual function and fertility. Moreover, the laparoscopic approach may offer additional advantages because a stepwise approach, which includes an initial colectomy with IRA which can be followed if necessary by RPC in patients with uncontrollable or large rectal polyps developing during follow up . Colectomy with IRA is usually performed in cases with a small number of polyps in the rectum and in patients compliant with a proctoscopic follow‐up.…”

“…The main advantages of the laparoscopic approach in colorectal surgery are safety, trauma reduction, improved short‐term outcome, less intraoperative blood loss, postoperative pain and immunosuppression, a reduced incidence of small bowel obstruction and incisional hernia formation, and shorter hospital stay. In addition, the cosmetic benefits are relevant in this young population . Another question is the development of desmoid tumours after surgery.…”