The Role of Re-laparoscopy in the Management of Complications Following Laparoscopic Rectal Cancer Surgery: A Retrospective Case Series

Document Type : Research/Original Article

Authors

Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: The benefits of laparoscopy versus open surgery for patients with rectal cancer have been well established. This study evaluates the role of re-laparoscopy in patients who develop complications following laparoscopic rectal cancer surgery.
Methods: This is a retrospective case series of 22 (5.9%) re-laparoscopy cases of the 373 rectal cancer patients with rectal cancer who underwent laparoscopic primary surgery at Omid, Ghaem, and Razavi hospitals in Mashhad, Iran, between July 2011 and December 2020.
Results: Twenty-two (5.9%) eligible patients with a mean±SD age of 50.9±10.4 years were included in the study, of which 15 (68.2%) were men and 7 (31.6%) were women. After 22 primary laparoscopic surgeries, anastomosis-fail/peritonitis was the most common complication requiring re-laparoscopy (n=9, 40.9%). Other complications included obstruction (n=8, 36.4%), bleeding (n=3, 13.6%), and intestinal injury (n=2, 9.1%). The complications of all patients (n=22) who underwent re-laparoscopy were successfully managed by re-laparoscopy.
Conclusion: In the case of available facilities and the presence of an experienced surgeon in the medical center, re-laparoscopy for managing complications following laparoscopic rectal cancer surgery appears to be safe and effective in selected patients.

Keywords

References

  1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 1991;1(3):144-50.
  2. Halkias C, Zoikas A, Garoufalia Z, Konstantinidis MK, Ioannidis A, Wexner S. Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review. Journal of clinical medicine. 2021;10(7).
  3. Angeramo CA, Schlottmann F, Laporte M, Bun ME, Rotholtz NA. Re-laparoscopy to Treat Early Complications After Colorectal Surgery: Is There a Learning Curve? Surgical laparoscopy, endoscopy & percutaneous techniques. 2022;32(3):362-7.
  4. Ibáñez N, Abrisqueta J, Luján J, Sánchez P, Soriano MT, Arevalo-Pérez J, et al. Reoperation after laparoscopic colorectal surgery. Does the laparoscopic approach have any advantages? Cirugia espanola. 2018;96(2):109-16.
  5. Chang KH, Bourke MG, Kavanagh DO, Neary PC, O’Riordan JM. A systematic review of the role of re-laparoscopy in the management of complications following laparoscopic colorectal surgery. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 2016;14(5):287-93.
  6. O’Riordan JM, Larkin JO, Mehigan BJ, McCormick PH. Re-laparoscopy in the diagnosis and treatment of postoperative complications following laparoscopic colorectal surgery. The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 2013;11(4):183-6.
  7. Wright DB, Koh CE, Solomon MJ. Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery. The British journal of surgery. 2017;104(4):337-46.
  8. McCormick JT, Simmang CL. Reoperation following minimally invasive surgery: are the “rules” different? Clinics in colon and rectal surgery. 2006;19(4):217-22.
  9. Fransvea P, Costa G, D’Agostino L, Sganga G, Serao A. Redo-laparoscopy in the management of complications after laparoscopic colorectal surgery: a systematic review and meta-analysis of surgical outcomes. Techniques in coloproctology. 2021;25(4):371-83.
  10. Cimitan A, Contardo T, Molaro R, Morpurgo E. The Role of Laparoscopy in the Treatment of Anastomotic Leaks After Minimally Invasive Colorectal Resections for Cancer. Surgical laparoscopy, endoscopy & percutaneous techniques. 2016;26(4):e80-4.
  11. McAllister I, Sagar PM, Brayshaw I, Gonsalves S, Williams GL. Laparoscopic restorative proctocolectomy with and without previous subtotal colectomy. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2009;11(3):296-301.
  12. Rotholtz NA, Laporte M, Lencinas SM, Bun ME, Aued ML, Mezzadri NA. Is a laparoscopic approach useful for treating complications after primary laparoscopic colorectal surgery? Diseases of the colon and rectum. 2009;52(2):275-9.
  13. Rosin D, Zmora O, Khaikin M, Bar Zakai B, Ayalon A, Shabtai M. Laparoscopic management of surgical complications after a recent laparotomy. Surgical endoscopy. 2004;18(6):994-6.
  14. Novitsky YW, Litwin DE, Callery MP. The net immunologic advantage of laparoscopic surgery. Surgical endoscopy. 2004;18(10):1411-9.
  15. Vennix S, Bakker OJ, Prins HA, Lips DJ. Re-interventions following laparoscopic surgery for colorectal cancer: data from 818 individuals from the Dutch surgical colorectal audit. Journal of laparoendoscopic & advanced surgical techniques Part A. 2014;24(11):751-5.
  16. Vignali A, Elmore U, Aleotti F, Roberto D, Parise P, Rosati R. Re-laparoscopy in the treatment of anastomotic leak following laparoscopic right colectomy with intracorporeal anastomosis. Surgical endoscopy. 2021;35(11):6173-8.
  17. Wind J, Koopman AG, van Berge Henegouwen MI, Slors JF, Gouma DJ, Bemelman WA. Laparoscopic reintervention for anastomotic leakage after primary laparoscopic colorectal surgery. The British journal of surgery. 2007;94(12):1562-6.
  18. Lee CM, Huh JW, Yun SH, Kim HC, Lee WY, Park YA, et al. Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery. Surgical endoscopy. 2015;29(4):931-6.
  19. Numata M, Yamaguchi T, Kinugasa Y, Shiomi A, Kagawa H, Yamakawa Y, et al. Safety and feasibility of laparoscopic reoperation for treatment of anastomotic leakage after laparoscopic colorectal cancer surgery. Asian journal of endoscopic surgery. 2018;11(3):227-32.
  20. Mancini GJ, Petroski GF, Lin WC, Sporn E, Miedema BW, Thaler K. Nationwide impact of laparoscopic lysis of adhesions in the management of intestinal obstruction in the US. Journal of the American College of Surgeons. 2008;207(4):520-6.
  21. O’Connor DB, Winter DC. The role of laparoscopy in the management of acute small-bowel obstruction: a review of over 2,000 cases. Surgical endoscopy. 2012;26(1):12-7.
  22. Sebastian-Valverde E, Poves I, Membrilla-Fernández E, Pons-Fragero MJ, Grande L. The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction. BMC surgery. 2019;19(1):40.
  23. Holub Z, Jabor A. Laparoscopic management of bleeding after laparoscopic or vaginal hysterectomy. JSLS: Journal of the Society of Laparoendoscopic Surgeons. 2004;8(3):235-8.
  24. Gong EM, Zorn KC, Gofrit ON, Lucioni A, Orvieto MA, Zagaja GP, et al. Early laparoscopic management of acute postoperative hemorrhage after initial laparoscopic surgery. Journal of endourology. 2007;21(8):872-8.
  25. Kirshtein B, Domchik S, Mizrahi S, Lantsberg L. Laparoscopic diagnosis and treatment of postoperative complications. The American journal of surgery. 2009;197(1):19-23.
  26. Park SY, Choi GS, Jun SH, Park JS, Kim HJ. Laparoscopic salvage surgery for recurrent and metachronous colorectal cancer: 15 years’ experience in a single center. Surgical endoscopy. 2011;25(11):3551-8.
Iranian Journal of Colorectal Research
Volume 11, Issue 4
December 2023
Pages 128-133

Files

Share

How to cite

Statistics