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Published in: Surgical Endoscopy 8/2009

01-08-2009

The feasibility of laparoscopic colectomy in urgent and emergent settings

Authors: Brad Champagne, Jonah J. Stulberg, Zhen Fan, Conor P. Delaney

Published in: Surgical Endoscopy | Issue 8/2009

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Abstract

Background

Laparoscopic colectomy (LC) is slowly becoming the standard of care for elective resections. However, the use of LC in the emergency setting is relatively unstudied. The authors describe their experience with a series of emergent and urgent LC cases for a variety of colorectal pathologies.

Methods

This study reviewed 20 consecutive patients who had a laparoscopic emergent or urgent colectomy over a 2-year period. Patient demographics, indications for surgery, operative details, and postoperative complications were examined.

Results

Two cases were converted to open procedure, and the mean operative time was 162 min (median, 163 min). The average postoperative length of hospital stay was 8.1 days (median, 6 days). There was one reoperation and three readmissions within 30 days, with no mortality during the follow-up period. Six patients required intensive care unit (ICU) stays after surgery, and 40% of the patients had one or more postoperative complications.

Conclusions

With increasing experience, LC is a feasible option in nonelective situations. Further prospective and comparative studies will improve our understanding of the outcomes for emergency LC.
Literature
1.
go back to reference Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of nonmetastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of nonmetastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef
2.
go back to reference Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
3.
go back to reference Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef
4.
go back to reference Garrett KA, Champagne BJ, Valerian BT, Peterson D, Lee EC (2008) A single training center’s experience with 200 consecutive cases of diverticulitis: can all patients be approached laparoscopically? Surg Endosc 22(11):2503–2508PubMedCrossRef Garrett KA, Champagne BJ, Valerian BT, Peterson D, Lee EC (2008) A single training center’s experience with 200 consecutive cases of diverticulitis: can all patients be approached laparoscopically? Surg Endosc 22(11):2503–2508PubMedCrossRef
5.
go back to reference Lee SW, Yoo J, Dujovny N, Sonoda T, Milsom JW (2006) Laparoscopic vs hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 49:464–469PubMedCrossRef Lee SW, Yoo J, Dujovny N, Sonoda T, Milsom JW (2006) Laparoscopic vs hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 49:464–469PubMedCrossRef
6.
go back to reference Ng SS, Yiu RY, Li JC, Lee JF, Leung KL (2006) Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma. J Laparoendosc Adv Surg Tech A 16:350–354PubMedCrossRef Ng SS, Yiu RY, Li JC, Lee JF, Leung KL (2006) Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma. J Laparoendosc Adv Surg Tech A 16:350–354PubMedCrossRef
7.
go back to reference Koea JB, Guillem JG, Conlon KC, Minsky B, Saltz L, Cohen A (2000) Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer. J Gastrointest Surg 4:105–108PubMedCrossRef Koea JB, Guillem JG, Conlon KC, Minsky B, Saltz L, Cohen A (2000) Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer. J Gastrointest Surg 4:105–108PubMedCrossRef
8.
go back to reference Marcello PW, Milsom JW, Wong SK, Brady K, Goormastic M, Fazio VW (2001) Laparoscopic total colectomy for acute colitis: a case-control study. Dis Colon Rectum 44:1441–1445PubMedCrossRef Marcello PW, Milsom JW, Wong SK, Brady K, Goormastic M, Fazio VW (2001) Laparoscopic total colectomy for acute colitis: a case-control study. Dis Colon Rectum 44:1441–1445PubMedCrossRef
9.
go back to reference Bleier JI, Moon V, Feingold D, Whelan RL, Arnell T, Sonoda T, Milsom JW, Lee SW (2008) Initial repair of iatrogenic colon perforation using laparoscopic methods. Surg Endosc 22:646–649PubMedCrossRef Bleier JI, Moon V, Feingold D, Whelan RL, Arnell T, Sonoda T, Milsom JW, Lee SW (2008) Initial repair of iatrogenic colon perforation using laparoscopic methods. Surg Endosc 22:646–649PubMedCrossRef
10.
go back to reference Fowkes L, Krishna K, Menon A, Greenslade GL, Dixon AR (2008) Laparoscopic emergency and elective surgery for ulcerative colitis. Colorectal Dis 10:373–378PubMedCrossRef Fowkes L, Krishna K, Menon A, Greenslade GL, Dixon AR (2008) Laparoscopic emergency and elective surgery for ulcerative colitis. Colorectal Dis 10:373–378PubMedCrossRef
Metadata
Title
The feasibility of laparoscopic colectomy in urgent and emergent settings
Authors
Brad Champagne
Jonah J. Stulberg
Zhen Fan
Conor P. Delaney
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-0227-z

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