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To assess the safety, feasibility and results of laparoscopic total abdominal colectomy for severy acute ulcerative colitis or in patients who had failed long-term medical management and were considered too unfit for a restorativeproctocolectomy.A retrospective study based on aprospective collected database. Pre-and perioperative parameters, morbidity, and mortality were analyzed.In 5 years 50 patients with ulcerative colitis were operated by laparoscopy. Of them, 28 (56%) required an emergency surgery. Twenty patients had severe disease and were performed as emergencies and eight had failed long term medical management and were considered too unfit for a restorativeproctocolectomy. 16 (57%) were men and average age was 33 (4-68) years. Average albumin was 31.7 (19.5-46.4) g/l. Average operative time was 189 (130-300) min. Conversion rate was 4%. Average hospital stay was 4.1 (3-10) days. Postoperative complications rate was 29%: three urinary retentions, two minor stoma complications, one deep vein thrombosis and two small bowel obstruction. There were no mortality. The average time to completeproctectomy with ileoanal J pouch was 87 (38-385) days and the conversion rate for this second step was 11%.Laparoscopic total colectomy for severely acute ulcerative colitis is safe and feasible.