Relaparoscopy for management of postoperative complications following colorectal surgery: ten years experience in a single center

Cuccurullo, Diego; Pirozzi, Felice; Sciuto, Antonio; Bracale, Umberto; Barbera, C.; Galante, Francesco; Corcione, Francesco

doi:10.1007/s00464-014-3862-6

Cited by 50 publications

(41 citation statements)

References 42 publications

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“…The largest study reported strong evidence that LR reduced mortality, even after controlling for multiple confounding factors (adjusted odds ratio 0·30, P < 0·001). The study with the highest mortality rate following LR (6 per cent) reported deaths from septic shock, myocardial infarction and pulmonary embolism.…”

Section: Resultsmentioning

confidence: 98%

“…In the study by Joh and colleagues 28 , all patients underwent laparoscopic exploration before deciding the operative approach. Five studies 26,28,29,33,34 reported indications for specific operative procedures after intraoperative identification of the postoperative complication. The definition of early reoperation varied across reports, with one study 34 using 6 weeks as the cut-off, and another 31 30 days.…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the identified studies was assessed as low overall owing to a lack of defined selection criteria, blinding in assessment of outcomes, and standardized classifications for the diagnosis and reporting of complications ( Table 2). The likelihood of confounding variables was assessed as 27 High High Low High Low High Joh et al 28 High High Low High Low High Kwak et al 29 High High Low High Low High Pinto et al 30 Low High Low High Low High Haas et al 31 High High Low High Low Low Vennix et al 32 Unclear High Low Unclear Unclear Low Cuccurullo et al 33 High High Low High Low High Lee et al 34 High High Low High Low Low Borghi et al 35 High High Low High Low Low…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery

Wright

Koh

Solomon

2017

British Journal of Surgery

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery

Wright

Koh

Solomon

2017

British Journal of Surgery

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“…[5]. The Laparoscopic approach (LA) represents the gold standard treatment in many abdominal diseases [6]. It provides an alternative to an open approach that may reduce postoperative pain, postoperative complications and result in a shorter hospitality stay.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic treatment of abdominal unicentric castleman’s disease: a case report and literature review

et al. 2017

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BackgroundCastleman’s disease is a rare lymphoproliferative disorder of unknown etiology that most commonly presents as a mediastinal nodal mass. It is exceptionally uncommon for Castleman’s disease to present in the mesentery and, only 53 cases have ever been described in the literature. Standard treatment for this lymphoproliferative disorder involving a single node is a complete “en bloc” surgical resection which has proven to be a curative approach in almost all cases without recurrence after 20 years of follow up. All 53 reported cases of mesenteric Castleman’s disease, except one, were treated with laparotomy.Case presentationWe report on a case of mesenteric Castleman’s disease localized in the mesentery which is the second reported case if its kind and was treated by a laparoscopic-assisted procedure. Our female patient had an uneventful postoperative course and was discharged in the 5th post-operative day. No signs of recurrence were present as evidenced by physical examination and total body CT scan 24 months after the operation. We compare our case with the other reported cases in which Castleman’s disease presented as an isolated mass in the abdomen.ConclusionAlthough a rare disease, Unicentric Castleman’s disease should always be considered when a solid asymptomatic abdominal mass is occasionally presented. The laparoscopic approach (LA) allows for the achievement of better results than open surgery, including a reduction in postoperative pain and length of hospital stay. In cases of masses of an uncertain nature, LA must be considered the last diagnostic tool and the first treatment one.

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“…Until now, only few reports are available in published papers about outcomes of laparoscopic treatment of postoperative complications after open or laparoscopic surgery. According to current trends, gradually laparoscopy has begun to be the preferred method to manage patients with suspected postoperative complications [14]. In this paper, we report our experience about revision, re-exploration and solution of complications of surgical procedures previously performed both in open and in laparoscopic way.…”

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confidence: 99%

“Relaparoscopic” management of surgical complications: The experience of an Emergency Center

et al. 2015

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Background/aim Laparotomy has been the approach of choice for re-operations in patients with surgical complications. The aim of this retrospective analysis was to evaluate the feasibility and the safety of laparoscopic approach for the management of general abdominal surgery complications. Materials and methods We report a retrospective review of 75 patients who underwent laparoscopic evaluation for postoperative complications over a 4-year period. Primary outcomes (resolution rate by exclusive laparoscopic approach, conversion rate, further surgery rate) and secondary outcomes (mortality, hospitalization, prolonged ileus, wounds problems and median operative time) were evaluated. Results Sixty-six patients (88 %) were managed with laparoscopic approach without conversion; of these, sixtythree patients (84 %) had no more or further complications and were discharged from hospital between 4 ± 3 days after ''second-look'' surgery; three patients (4 %) developed postoperative complications requiring a third surgery.Nine cases (12 %) underwent conversion in open surgery after laparoscopic approach. Two elderly patients (2.7 %) died in intensive care unit, because of multi-organ failure syndrome. Median time elapsed between an intervention and another was about 2.5 ± 9.5 days. Mean operative time was 90 ± 150 min. Postoperative hospital stay was between 4.5 and 18 days. Discussion and conclusion Laparoscopy has begun to be the preferred method to manage postoperative problems, but only few reports are available actually. Our experience in ''relaparoscopic'' management of surgical complications seems to suggest that laparoscopy ''second look'' is an effective tool after open or laparoscopic surgery for the management of postoperative complications and it may avoid diagnostic delay and further laparotomy and related problems.

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Relaparoscopy for management of postoperative complications following colorectal surgery: ten years experience in a single center

Abstract: Laparoscopy is a safe and effective tool for management of complications following laparoscopic colorectal surgery. In this setting, RL represents the first step of re-exploration and treatment, with no delay to conversion to open procedure even in skilled laparoscopic hands.

Cited by 50 publications

References 42 publications

Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery

Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery

Laparoscopic treatment of abdominal unicentric castleman’s disease: a case report and literature review

“Relaparoscopic” management of surgical complications: The experience of an Emergency Center

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