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Laparoscopic‐assisted colectomy with Duhamel procedure for idiopathic megacolon in adults: a retrospective study
Author(s) -
Wang Li,
Zheng Huichao,
Tian Yue,
Mou Jianghong,
Zhang Lianyang,
Liu Baohua,
Tong WeiDong
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15868
Subject(s) - medicine , surgery , colectomy , anastomosis , ileostomy , laparoscopy , retrospective cohort study , megacolon , general surgery , ulcerative colitis , disease
Background Idiopathic megacolon (IMC) is an uncommon disease in adults. To date, only a few laparoscopic experiences and functional outcomes of IMC have been reported. This study was to retrospectively analyse our 12 year surgical experience and functional outcomes in adult patients with IMC. Methods A 12‐year retrospective study from October 2006 to November 2018 was performed for patients with IMC who underwent surgical interventions. Patients who underwent laparoscopic‐assisted colectomy and Duhamel procedure with ileorectal or colorectal anastomosis were collected. Clinical data of surgery and functional outcomes were analysed. Results A total of 13 patients who underwent surgical interventions were included in the study. Seven patients underwent laparoscopic total colectomy with ileorectal anastomosis (Duhamel procedure), one patient underwent laparoscopic total colectomy with end ileostomy because of acute intestinal obstruction, while five other patients underwent laparoscopic segmental colectomy with colorectal anastomosis (Duhamel procedure). The mean operative time was 181.6 min (range 150–246). The mean estimated blood loss was 75.6 ml (range 40–200). The mean postoperative hospital stay was 8.2 days (range 6–13). There was no conversion to an open procedure and no surgical mortality. Postoperative diarrhoea was the most prominent complaint during the early period after total colectomy. All patients showed adaptation to the defaecation frequency 3–6 months postoperatively, and had a good quality of life in long‐term follow‐up. Conclusion Laparoscopic‐assisted colectomy with Duhamel procedure is a safe and efficient technique for IMC in adults. The scope of colon resection and the type of anastomosis should be individually selected.