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Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery

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Abstract

Purpose

The aim of this study is to evaluate the safety and feasibility of laparoscopic reintervention compared with open surgery in patients with anastomotic leakage after minimally invasive colorectal surgery.

Methods

Between January 2008 and December 2012, 77 patients who required surgical reintervention for anastomotic leakage following minimally invasive colorectal surgery were included in this study. Data on the patients’ demographics, operative management, morbidity, hospital stay, and mortality were analyzed for differences based on whether they received laparoscopic or open surgery.

Results

Sixteen patients underwent open surgery following laparoscopy, and 61 patients received laparoscopic reintervention following laparoscopy. The conversion rate was 8.2 % (5/61). The median total hospital stay following reintervention was significantly shorter for laparoscopic surgery (16.0 days, range 9–117 days) than for open surgery (35.5 days, range 10–135 days, p < 0.001). The postoperative 30-day morbidity rate, including wound dehiscence (25.0 vs 3.3 %, p = 0.015) and intra-abdominal infection (31.3 vs 6.6 %, p = 0.016), was lower in the laparoscopic surgery group than in the open surgery group. The rate of stoma closure was lower in the open surgery group than in the laparoscopic surgery group (43.8 vs 80.5 %, p < 0.001). There was one in-hospital mortality in the open surgery group.

Conclusions

Laparoscopic reintervention for anastomotic leakage following minimally invasive colorectal surgery is associated with a shorter hospital stay, fewer postoperative complications, and a higher stoma closure rate than open surgery. Laparoscopic reintervention for anastomotic leakage is feasible and safe.

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Disclosures

Chul Min Lee, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, and Ho-Kyung Chun declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea

    Chul Min Lee, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Yoon Ah Park & Yong Beom Cho

  2. Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Ho-Kyung Chun

Authors
  1. Chul Min Lee
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  2. Jung Wook Huh
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  3. Seong Hyeon Yun
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  4. Hee Cheol Kim
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  5. Woo Yong Lee
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  8. Ho-Kyung Chun
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Correspondence to Jung Wook Huh.

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Lee, C.M., Huh, J.W., Yun, S.H. et al. Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery. Surg Endosc 29, 931–936 (2015). https://doi.org/10.1007/s00464-014-3755-8

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  • DOI: https://doi.org/10.1007/s00464-014-3755-8

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