Redo-laparoscopy in the management of complications after laparoscopic colorectal surgery: a systematic review and meta-analysis of surgical outcomes

Fransvea, Pietro; Costa, Gianluca; D’Agostino, Luca; Sganga, Gabriele; Serao, Angelo

doi:10.1007/s10151-020-02374-8

Cited by 13 publications

(20 citation statements)

References 43 publications

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“…Consistent with previous data on laparoscopic surgery, all of the studies included in this systematic review did show a significantly smaller range of mean days of hospital stay for laparoscopy. Fransvea et al [ 8 ], in their meta-analysis on the laparoscopic treatment of complications, also confirmed the above observations (WMD = −0/0 95% CI −1.04 to −0.76, p < 0.001) with statistically significant results. This is not a surprise given the experience we have on previous studies suggesting positive postoperative effects of laparoscopic surgery, such as better pulmonary function and reduced postoperative pain.…”

Section: Discussionmentioning

confidence: 59%

“…In all of the above studies, there was no statistically different result in terms of morbidity. Fransvea et al [ 8 ], in their meta-analysis with the limitation of a fixed effect model, did show a statistically significant difference favoring laparoscopy (OR = −0.97; 95% CI −1.63 to −0.29; Z = −2.84; p = 0.005).…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review and meta-analysis by Fransvea et al [ 8 ] showed low morbidity, mortality, and conversion rates in the laparoscopic treatment of complications after colorectal surgery. Our systematic review is the first one to approach redo laparoscopic surgery as an entity itself, and not to focus only on complications.…”

Section: Discussionmentioning

confidence: 99%

“…Redo laparoscopic surgery, regardless of the intervention, has been proven to have a low mortality rate in previous studies [ 1 , 5 , 8 ]. Our limited pooled data analysis showed a 2.78% mortality rate in the laparoscopic arm compared to 9.4% in the open arm.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic re-operative surgery can be challenging, especially in relation to postoperative complications. There is a lack of evidence supporting a laparoscopic approach to re-operation after colorectal surgery, and the systematic reviews available only concern the management of complications [ 7 , 8 ]. The aim of this study is to systematically appraise the relevant literature to identify the efficacy of re-operative colorectal surgery in all relevant occasions, such as the management of complications, re-operation for recurrent malignancy, or other benign conditions.…”

Section: Introductionmentioning

confidence: 99%

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Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review

Halkias

Zoikas

Garoufalia

et al. 2021

JCM

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Introduction: Re-operative laparoscopic colorectal surgery is becoming increasingly common. It can be a challenging procedure, but its benefits can outweigh the associated risks. Methods: A systematic review of the literature reporting re-operative laparoscopic surgery was carried out. Retrospective and prospective cohort studies and case series were included, with case reports being excluded. Results: Seventeen articles dated from 2007 to 2020 were included in the systematic review. In total, 1555 patients were identified. Five hundred and seventy-four of them had a laparoscopic procedure and 981 an open re-operation. One hundred and eighty-three women had a laparoscopic operation. The median age ranged from to 44.9 years to 68.7 years. In seven studies, the indication of the index operation was malignancy, one study regarded re-laparoscopy for excision of lateral pelvic lymph nodes, and one study looked at redo surgery of ileal J pouch anal anastomosis. There were 16 mortalities in the laparoscopic arm (2.78%) and 93 (9.4%) in the open surgery arm. One hundred and thirty-seven morbidities were recorded in the open arm and 102 in the laparoscopic arm. Thirty-nine conversions to open occurred. The median length of stay ranged from 5.8 days to 19 days in laparoscopy and 9.7 to 34 days in the open surgery arm. Conclusions: Re-operative laparoscopic colorectal surgery is safe when performed by experienced hands. The management of complications, recurrence of malignancy, and lateral pelvic floor dissection can be safely performed. The complication rate is low, with conversion to open procedures being relatively uncommon.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review

Halkias

Zoikas

Garoufalia

et al. 2021

JCM

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Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

Ando

Takahashi

Fujii

et al. 2021

Annals of Gastroent Surgery

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Implementing protocol‐based relaparoscopy for severe complications in laparoscopic colorectal surgery

Puccetti,

Vallorani,

Cinelli

et al. 2024

World j. surg.

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BackgroundAlthough laparoscopy has demonstrated growing applications for either primary colorectal resections or reoperations, no standardized criteria for implementing laparoscopy in revisional surgery have been reported. This study analyzes a single‐center series of major complications after laparoscopic colorectal surgery, undergoing laparoscopic (LR), or open reoperations in compliance with a hemodynamics‐based institutional management.MethodsThis study retrospectively analyzes a series of consecutive patients who primarily underwent either laparoscopic left colectomy or low anterior resection in a tertiary referral center between 2016 and 2021. Major complications requiring reoperation (MCR) were managed through an interdisciplinary protocol and submitted to reoperation according to patient hemodynamics and intra‐abdominal contamination. A cohort analysis primarily assessed treatment failure rates (i.e., 90‐day mortality and need for further surgery), while postoperative morbidity was secondarily examined.ResultsOut of 1137 laparoscopic colorectal resections, 497 patients met eligibility criteria, while 45 (9.1%) developed MCRs were managed according to the standardized interdisciplinary protocol. Revisional surgery was performed through either LR (66.7%) or (33.3%). Treatment failure was 13.3% overall, including additional surgery (11.1%) and 90‐day mortality (6.6%) after reoperation. In both overall and anastomotic leak‐specific MCRs, relaparoscopy resulted in minimized length of hospital stay, postoperative morbidity, and intensity of care.ConclusionsRelaparoscopy for MCR preserves clinical benefits related to minimally invasive colorectal surgery. Further studies should investigate applicative determinants and impediments related to the center volume.

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Redo-laparoscopy in the management of complications after laparoscopic colorectal surgery: a systematic review and meta-analysis of surgical outcomes

Cited by 13 publications

References 43 publications

Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review

Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan

Implementing protocol‐based relaparoscopy for severe complications in laparoscopic colorectal surgery

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