Feasibility of Emergency Laparoscopic Reoperations for Complications after Laparoscopic Surgery for Colorectal Cancer

다국어 초록 (Multilingual Abstract)

Purpose: Laparoscopic surgery (LS) is an alternative to colorectal cancer surgery. Little evidence supports LS for emergency reoperation after laparoscopic colorectal surgery. The aim of this study was to assess perioperative outcomes of LS as an emergency reoperation for early complications after LS for colorectal cancer.
Methods: From June 2006 through December 2016, 732 consecutive patients underwent elective LS for colorectal cancer at Kyung Hee University Hospital, Seoul, Korea. Among these patients, we retrospectively reviewed data on those who received emergency laparoscopic reoperations for complications within 30 days after surgery. Variables associated with perioperative outcomes were analyzed.
Results: After exclusion of 50 patients (6.8%) who needed conversion to open surgery during LS, 79 of 682 patients (11.6%) received reoperation for complications, recurrence, and other benign diseases.
Among them, 22 patients underwent emergency laparoscopic reoperation for early complications.
Mean age of the patients was 62 years, and most underwent low anterior resection as a primary operation (n=17, 77.3%). Anastomotic leakage was the most common reason for reoperation (n=14, 63.6%). Postoperative complication occurred in 6 patients (27.3%), but none required further surgical intervention. Patients had first bowel movements at 2.8 days after reoperation, and length of hospital stay was 17.2 days after reoperation.
Conclusion: Laparoscopic reoperation showed acceptable outcomes. LS as a reoperation for complications seemed to be feasible after LS for colorectal cancer.

참고문헌 (Reference)

1 Agresta F, "The laparoscopic approach in abdominal emergencies: has the attitude changed?: A single-center review of a 15-year experience" 22 : 1255-1262, 2008

2 Vennix S, "Surgical re-interventions following colorectal surgery: open versus laparoscopic management of anastomotic leakage" 23 : 739-744, 2013

3 Guillou PJ, "Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial" 365 : 1718-1726, 2005

4 Wang L, "Outcomes of laparoscopic colorectal surgery in patients of previous abdominal surgery: a systemic review and meta-analysis" 62 : 273-278, 2015

5 Burns EM, "Minimalaccess colorectal surgery is associated with fewer adhesion-related admissions than open surgery" 100 : 152-159, 2013

6 Lacy AM, "Laparoscopyassisted colectomy versus open colectomy for treatment of nonmetastatic colon cancer: a randomised trial" 359 : 2224-2229, 2002

7 Kennedy GD, "Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program" 249 : 596-601, 2009

8 Lee CM, "Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery" 29 : 931-936, 2015

9 Wind J, "Laparoscopic reintervention for anastomotic leakage after primary laparoscopic colorectal surgery" 94 : 1562-1566, 2007

10 Rosin D, "Laparoscopic management of surgical complications after a recent laparotomy" 18 : 994-996, 2004

11 Navez B, "Laparoscopic management of acute peritonitis" 85 : 32-36, 1998

12 Kiran RP, "Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program" 211 : 232-238, 2010

13 Rotholtz NA, "Is a laparoscopic approach useful for treating complications after primary laparoscopic colorectal surgery?" 52 : 275-279, 2009

14 Jayne DG, "Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer" 97 : 1638-1645, 2010

15 Kirshtein B, "Early relaparoscopy for management of suspected postoperative complications" 12 : 1257-1262, 2008

16 Clinical Outcomes of Surgical Therapy Study Group, "A comparison of laparoscopically assisted and open colectomy for colon cancer" 350 : 2050-2059, 2004