Offen chirurgische versus laparoskopische Versorgung der iatrogenen Kolonperforation - Ergebnisse nach 13 Jahren Erfahrungen

Schlöricke, Erik; Bader, Franz G.; Hoffmann, Martin; Zimmermann, Markus; Bruch, Hans–Peter; Hildebrand, P.

doi:10.1055/s-0031-1271380

Cited by 16 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The authors found fewer complications and a shorter length of hospital stay for the patients in the laparoscopic group [ 110 ]. Other studies by Rothold et al [ 125 ] and Schloricke et al [ 127 ] also observed fewer postoperative complications and significantly shorter hospital stays when utilizing the laparoscopic approach. Similar studies with similar results were published by Coimbra et al [ 124 ] and Kim et al [ 128 ], although in these studies, delayed surgeries (> 24 h) and ostomy formation rates were more frequently observed in the open groups, with higher primary repair rates in the laparoscopic groups.…”

Section: Resultsmentioning

confidence: 80%

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

de’Angelis

Saverio²,

Chiara

et al. 2018

World J Emerg Surg

View full text Add to dashboard Cite

Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45–60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator’s level of experience, and surgical device availability.Although ICPs have been the focus of numerous publications, no guidelines have been created to standardize the management of ICPs. The aim of this article is to present the World Society of Emergency Surgery (WSES) guidelines for the management of ICP, which are intended to be used as a tool to promote global standards of care in case of ICP. These guidelines are not meant to substitute providers’ clinical judgment for individual patients, and they may need to be modified based on the medical team’s level of experience and the availability of local resources.

show abstract

Section: Resultsmentioning

confidence: 80%

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

de’Angelis

Saverio²,

Chiara

et al. 2018

World J Emerg Surg

View full text Add to dashboard Cite

show abstract

“…Four studies were performed in single centers [ 26 , 37 – 39 ], whereas 2 were bi-centric studies [ 25 , 40 ]. Two studies were conducted in Asia [ 37 , 39 ], two in Europe [ 25 , 38 ], and two in North America [ 26 , 40 ]. Overall, they analyzed a total of 161 patients undergoing laparoscopic or open surgeries for ICP treatment.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic vs. open surgery for the treatment of iatrogenic colonoscopic perforations: a systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

AimsIatrogenic colonoscopy perforations (ICP) are a rare but severe complication of diagnostic and therapeutic colonoscopies. The present systematic review and meta-analysis aims to investigate the operative and post-operative outcomes of laparoscopy vs. open surgery performed for the management of ICP.MethodsA literature search was carried out on Medline, EMBASE, and Scopus databases from January 1990 to June 2016. Clinical studies comparing the outcomes of laparoscopic and open surgical procedures for the treatment for ICP were retrieved and analyzed.ResultsA total of 6 retrospective studies were selected, including 161 patients with ICP who underwent surgery. Laparoscopy was used in 55% of the patients, with a conversion rate of 10%. The meta-analysis shows that the laparoscopic approach was associated with significantly fewer post-operative complications compared to open surgery (18.2% vs. 53.5% respectively; Relative risk, RR: 0.32 [95%CI: 0.19–0.54; p < 0.0001; I2 = 0%]) and shorter hospital stay (mean difference −5.35 days [95%CI: −6.94 to −3.76; p < 0.00001; I2 = 0%]). No differences between the two surgical approaches were observed for postoperative mortality, need of re-intervention, and operative time.ConclusionThe present study highlights the outcomes of the surgical management of an endoscopic complication that is not yet considered in clinical guidelines. Based on the current available literature, the laparoscopic approach appears to provide better outcomes in terms of postoperative complications and length of hospital stay than open surgery in the case of ICP surgical repair. However, the creation of large prospective registries of patients with ICP would be a step forward in addressing the lack of evidence concerning the surgical treatment of this endoscopic complication.Electronic supplementary materialThe online version of this article (doi:10.1186/s13017-017-0121-x) contains supplementary material, which is available to authorized users.

show abstract

“…In contrast to other methods, such as the open low anterior resection of the rectum, there is a significant discrepancy between the size of the surgical wound and the surgical specimen that is removed during the operation [ 8 , 9 ]. Hence, laparoscopic pancreatic surgery could lead to a reduced intraoperative dysregulation of catecholamines or a reduced compromise of the immune system.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Pylorus- and Spleen-Preserving Duodenopancreatectomy for a Multifocal Neuroendocrine Tumor

et al. 2015

View full text Add to dashboard Cite

Background: In contrast to laparoscopic left pancreatic resection, laparoscopic total duodenopancreatectomy is a procedure that has not been standardized until now. It is not only the complexity that limits such a procedure but also its rare indication. The following article demonstrates the technical aspects of laparoscopic pylorus- and spleen-preserving duodenopancreatectomy. Case Report: The indication for intervention in the underlying case was a patient diagnosed with a multiple endocrine neoplasia (MEN) I syndrome and a multifocal neuroendocrine tumor (NET) infiltrating the duodenum and the pancreas. The patient was post median laparotomy which was necessary after jejunal perforation due to a peptic ulcer. The resection was carried out entirely laparoscopically, and the reconstruction, which included a biliodigestive anastomosis and a gastroenterostomy, was carried out by means of a median upper abdomen laparotomy of 7 cm in length through which the resected specimen was also removed. The total operative time was 391 min. The blood loss accounted for 250 ml. The postoperative course was uneventful, and the patient was discharged on the eighth postoperative day. Conclusion: Laparoscopic pancreatectomy is a treatment option in carefully selected indications. The complexity of the operation demands a high level of expertise in the surgical team.

show abstract

Offen chirurgische versus laparoskopische Versorgung der iatrogenen Kolonperforation - Ergebnisse nach 13 Jahren Erfahrungen

Cited by 16 publications

References 25 publications

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Laparoscopic vs. open surgery for the treatment of iatrogenic colonoscopic perforations: a systematic review and meta-analysis

Laparoscopic Pylorus- and Spleen-Preserving Duodenopancreatectomy for a Multifocal Neuroendocrine Tumor

Contact Info

Product

Resources

About