Re-laparoscopy in the treatment of anastomotic leak following laparoscopic right colectomy with intracorporeal anastomosis.
Andrea VignaliUgo ElmoreFrancesca AleottiDelpini RobertoPaolo PariseRiccardo RosatiPublished in: Surgical endoscopy (2020)
Laparoscopic approach was attempted in 23 (88.4%) hemodynamically stable patients. Conversion rate was 21.4%. Reasons for conversion were gross fecal peritonitis (n = 2), colonic ischemia (n = 1), severe bowel distension (n = 2). Eighteen (78.2%) patients underwent successfully laparoscopic (LPS) reoperation. A repair of the anastomotic defect was done in 11 (61.1%) patients, while in 7 patients the intracorporeal mechanical anastomosis was refashioned. A diverting ileostomy was done in 22.2% of cases (n = 4). A second reoperation for leak persistence was necessary in two cases (11.1%). Median (range) length of postoperative hospital stay from re-laparoscopy was 15.5 (9-53) days. Overall morbidity rate was 38.7%. Mortality rate was 5.5% (n = 1) CONCLUSION: laparoscopic re-intervention for the treatment of anastomotic leak following LPS right colectomy with intracorporeal anastomosis in hemodynamically stable and highly selected patients in the experienced hands of dedicated laparoscopic surgeons, is a safe option with acceptable morbidity and mortality rate.
Keyphrases
- end stage renal disease
- robot assisted
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- healthcare
- risk factors
- coronary artery disease
- rectal cancer
- cardiovascular disease
- emergency department
- patient reported outcomes
- patient reported
- quality improvement
- anti inflammatory
- acute care