The Role of Laparoscopy in the Treatment of Anastomotic Leaks After Minimally Invasive Colorectal Resections for Cancer
| Autor: | Tania Contardo, Roberta Molaro, Emilio Morpurgo, Andrea Cimitan |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Reoperation Leak medicine.medical_specialty medicine.medical_treatment Anastomotic Leak Video-Assisted Surgery Anastomosis Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Postoperative Complications Colostomy medicine Humans Prospective Studies Laparoscopy Prospective cohort study Colectomy Aged Aged 80 and over medicine.diagnostic_test business.industry Perioperative Middle Aged Surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female business Colorectal Neoplasms |
| Zdroj: | Surgical laparoscopy, endoscopypercutaneous techniques. 26(4) |
| ISSN: | 1534-4908 |
| Popis: | Aim of the study The aim of this study was to describe the role of laparoscopy in the treatment of leaks occurring after minimally invasive colorectal resections. Materials and methods Thirty-four of 566 consecutive patients who underwent minimally invasive colorectal resection for cancer between January 2004 and December 2012 and who showed signs of anastomotic leakage (6%) requiring reoperation were studied using a prospectively maintained database. Patient characteristics, clinical signs, the surgical approach, the role of laparoscopy, operative and postoperative results, and the rate of permanent stoma were analyzed. Results The median time to diagnosis of an anastomotic leak after surgery was 5.5 days. The median time to reoperation from the diagnosis of leakage was 2 days. Leaks were treated laparoscopically in 21 of 34 (61.8%) patients. Anastomoses were dismantled in 14 patients (41.2%) and the procedure was performed laparoscopically in 28.6% of the cases. The postoperative morbidity was 55.9%, the perioperative mortality 5.7%, and the rate of permanent stoma was 8.8%. Conclusions Laparoscopic reoperation can be performed in most cases of anastomotic leaks occurring after minimally invasive colorectal resection for cancer. Anastomosis can be dismantled laparoscopically in 28.6% of the cases. A permanent stoma was necessary only in patients with terminal stomas. |
| Databáze: | OpenAIRE |
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