Laparoscopic Total Colectomy Using Left-to-Right Dissection

PURPOSE: We compare the results of laparoscopic total colectomy using left-to-right dissection versus the open approach. METHODS: Twenty consecutive patients who underwent laparoscopic total colectomy using left-to-right dissection for familial adenomatous polyposis or synchronous colorectal cancer, were matched with 28 patients who underwent an open approach. RESULTS: No patients who underwent the laparoscopic procedure were converted to the open technique. The estimated blood loss was significantly lower in the laparoscopic group than in the open group (P=0.008). Although the operating time in the laparoscopic group was significantly longer (P<0.001), bowel function returned to the patients in this group 2 days sooner on average (P<0.001), and these patients were able to tolerate a soft diet 1 day earlier than the open group (P=0.005). There were no significant differences in postoperative complications between the 2 groups. CONCLUSIONS: Laparoscopic total colectomy using the left-to-right approach may be an alternative to open surgery for surgeons experienced with the laparoscopic technique.