Emergency laparoscopic colectomy: does it measure up to open?

Stulberg, Jonah J.; Champagne, Brad; Fan, Zhen; Horan, Mike; Obias, Vincent; Marderstein, Eric L.; Reynolds, Harry L.; Delaney, Conor P.

doi:10.1016/j.amjsurg.2008.09.010

Cited by 31 publications

(38 citation statements)

References 12 publications

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Section: Colorectal Emergenciesmentioning

confidence: 99%

“…lower gastrointestinal bleed, toxic colitis and colonic ischaemia [38,53]. Though majority are performed with a laparotomy, the laparoscopic approach has been described by a few authors [51,53]. Total laparoscopic surgery is performed by fewer [53] as others used predominantly laparoscopic-assisted or hand-assisted techniques [38].…”

Section: Colorectal Emergenciesmentioning

confidence: 99%

“…Though majority are performed with a laparotomy, the laparoscopic approach has been described by a few authors [51,53]. Total laparoscopic surgery is performed by fewer [53] as others used predominantly laparoscopic-assisted or hand-assisted techniques [38]. Majority of the limited available evidence favours laparoscopic surgery due to faster recovery and low complication rates [38,53,54].…”

Section: Colorectal Emergenciesmentioning

confidence: 99%

“…Total laparoscopic surgery is performed by fewer [53] as others used predominantly laparoscopic-assisted or hand-assisted techniques [38]. Majority of the limited available evidence favours laparoscopic surgery due to faster recovery and low complication rates [38,53,54]. One Danish study did not find laparoscopic subtotal colectomy a feasible option due to high complication rate and high conversion (48 %) [55].…”

Section: Colorectal Emergenciesmentioning

confidence: 99%

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Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

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Section: Colorectal Emergenciesmentioning

confidence: 99%

Section: Colorectal Emergenciesmentioning

confidence: 99%

Section: Colorectal Emergenciesmentioning

confidence: 99%

Section: Colorectal Emergenciesmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

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“…However, there is not the same confidence in the use of laparoscopic colorectal surgery in an emergency. 3,4 Although several reports have suggested that laparoscopic colectomy is safe and feasible even in emergency cases if the patients are appropriately selected, [5][6][7][8][9] the adoption of laparoscopy as a routine procedure in emergency colorectal surgery has been hampered. It is not only because of insufficient evidence of literature but also because of its technical difficulty.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Hand-Assisted Laparoscopic Surgery for Colorectal Disease in an Emergency Setting

Kim

Cheng

Lee

et al. 2017

J Minim Invasive Surg

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Purpose: Laparoscopic surgery is accepted as a standard alternative to open procedures in the management of both benign and malignant colorectal disease. However, the safety and efficacy of the laparoscopic approach for emergency colorectal surgery has not been established. Hand-assisted laparoscopic (HAL) surgery might be a suitable option for colectomy in an emergency setting. The aim of this study was to report our experience of emergency HAL colectomy. Methods:This was a retrospective review of consecutive colorectal emergency cases that were treated using HAL colectomy. Patient demographics, indications for surgery, operative details, and postoperative complications were examined.Results: From March 2015 to April 2016, 18 patients underwent emergency HAL colectomy for complicated colorectal disease. Eight patients (44%) had an obstruction that required intraoperative decompression procedure. Sixteen patients (89%) had a perforation (five of which were sealed perforations involving large abscesses and inflammatory changes). Eight patients underwent sigmoidectomy, four underwent anterior resection, one underwent low anterior resection, two underwent left hemicolectomy, and three underwent Hartmann's procedure. There were two instances of open conversion (11%). The median duration of surgery was 178 minutes. The median time to bowel function recovery and median postoperative stay were 3 days and 10 days, respectively. The postoperative complication rate associated with the operation was 33% (6/18). There was one postoperative mortality. Conclusion:For the experienced surgeon, HAL can be a reasonable option for emergency colorectal surgery.

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