Single access laparoscopic total colectomy for severe refractory ulcerative colitis

Table 1 Characteristics of patients undergoing total colectomy and end ileostomy for medically refractory colitis by laparoscopic access including how commenced and completed and by patient preoperative albumin

	Single port started (n = 27)	Single port completed (n = 24)	Single port completed, preop Alb > 30 (n = 18)	Single port completed, preop Alb < 30 (n = 6)	Multiport started (n = 12)	Multiport completed (n = 13)	Multiport completed, Alb > 30 (n = 12)
Median age (yr)	37	36	39	34.4	36.6	37.6	41
Range	19-59	19-59	19-59	29-45	18-70	31-70	33-69
Median BMI (kg/m2)	23.3	23	23.5	21.4	22.2	25.8	25.9
Range	18.9-31.8	18.9-31.8	18.9-31.8	20.1-24.7	17.3-38	17.3-38.9	17.3-38.9
Males	16 (59%)	14 (58%)	9 (50%)	4 (66%)	4 (33%)	4 (31%)	4 (33%)
Anti-TNF agents	16 (59%)	14 (58%)	9 (50%)	5 (83%)	7 (58%)	9 (69%)	8 (66%)
Median preop Alb	36	37	39	24.5	38	38	38
Range	17-44	17-44	30-44	17-28	15-43	27-44	32-44
Median preop Hb	12.9	12.6	13.1	10.4	11.6	11.9	12
Range	7.9-17.2	7.9-17.2	7.9-17.2	8.4-13.2	8.2-13.5	8.2-14.6	8.2-14.6
Median preop CRP	29	25	10	51	9	9	18.7
Range	1-221	1-221	1-53	21-221	1-7	1-71	1-71
Total OT time (min)	290	285	285	275	300	302	301
Range	100-395	100-380	100-380	250-363	200-423	200-420	200-420
Operative time (min)	182	180	180	177.5	205	235	230
Range	90-270	90-270	90-270	150-240	120-345	120-345	120-345
Postop length of stay	5	5	5	7.5	7.5	8	7
Range	3-21	3-21	3-9	3-12	4-31	4-23	4-23

Alb: Albumin; BMI: Body mass index; CRP: C-reactive protein; Hb: Haemoglobin; Min: Minutes; OT: Operating theatre; Preop: Preoperative.

Table 2 Characteristics of patients undergoing total colectomy and end ileostomy for medically refractory colitis by laparotomy (either at commencement or by completion)

	Laparotomy commenced (n = 7)	Laparotomy completed (n = 9)
Age (yr)	49	45
Range	26-73	22-73
Males	6 (85%)	8 (88%)
Preop Alb	30	27
Range	15-42	(15-42)
Median length of stay	11	16
Range	7-56	7-56

Alb: Albumin.

Table 3 Postoperative complications after laparoscopic total colectomy and end ileostomy presented for groups by how operation was commenced as per Clavian-Dindo (contracted form)

Complication grade	Definition by Clavien-Dindo	Single port group (n = 27)		Multiport group (n = 12)
First 30 d		n	Comment	n	Comment
I	Any deviation from postop course without intervention	3	Serous discharge from around stoma site (all patients albumin < 30)	3	Persistent pneumoperitoneum with pain; Non-cardiac chest pain, high output stoma
II	Pharmacological treatment	2	Parastomal wound infection; Portal vein thrombosis treated by anticoagulation diagnoses after discharge	2	Parastomal wound infection; Umbilical port infection (pt started single port, converted due to adhesions); Portal vein thrombosis treated by anticoagulation (CT diagnosis on day 2 postop in patient begun multiport and converted to open due to extreme colonic friability)
III	Surgical, endoscopic or radiological intervention	1	Return to theatre on day 4 postop for fascial release for oedematous stoma (pt with preop Alb < 30)	2	Radiological drain of intrabdominal collection in one patient started by single port but converted to multiport laparoscopy and in another started by multiport but converted to open (retroperitoneal colon perforations found at surgery)
IV/V	Life-threatening complication/Death	0	-	0	-
After 30 d			Median follow-up 12.3 mo		Median follow-up 10.5 mo
I		0	-	1	Parastomal hernia
III		2	Both parastomal hernia requiring repair. (One performed at time of complection proctectomy, other requiring urgent laparoscopic repair)

Alb: Albumin; Preop: Preoperative; CT: Computed tomography; pt: Pharmacological treatment.