Attempting a Laparoscopic Approach in Patients Undergoing Left-Sided Colorectal Surgery Who Have Had a Previous Laparotomy: Is it Feasible?

6Citations
Citations of this article
14Readers
Mendeley users who have this article in their library.
Get full text

Abstract

Background: The feasibility of a laparoscopic approach in patients who have had a prior laparotomy (PL) remains controversial. We hypothesized that laparoscopic colorectal resection was safe and feasible in patients with previous open abdominal surgery. Methods: A retrospective review (2007–2015) of all patients undergoing laparoscopic resection for sigmoid and rectal adenocarcinoma with or without prior midline laparotomy (NPL) was performed. Primary endpoints included conversion and perioperative morbidity. Secondary endpoints included length of stay and perioperative outcomes. Demographics, surgical history, oncologic staging, and short-term outcomes were reviewed. Results: We identified 211 patients, of whom 33 (15.6%) had a prior laparotomy. Significantly more patients in the PL group were female (76.2 vs. 52.8%, p = 0.004). Patients with PL were of similar age to NPL patients (69.3 vs. 62.5, p = 0.09), and comorbidities, tumor staging, and neoadjuvant therapy were comparable between groups (all p > 0.05). Additional trocar placement was significantly higher in PL group (33.3 vs. 17.4%, p = 0.03), while conversion rate did not reach statistical significance (24.2 vs. 12.9%, p = 0.08). The postoperative complication rate was comparable between PL and NPL patients (33.3 vs. 25.3%, respectively, p = 0.2). Conclusions: Prior laparotomy should not be a contraindication to patients undergoing laparoscopic colorectal surgery, though surgeons should anticipate a higher likelihood of conversion to open.

References Powered by Scopus

Laparoscopic surgery versus open surgery for colon cancer: Short-term outcomes of a randomised trial

1866Citations
N/AReaders
Get full text

Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer

840Citations
N/AReaders
Get full text

Peritoneal adhesions and their relation to abdominal surgery. A postmortem study

411Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Early unplanned reoperations after gastrectomy for gastric cancer are different between laparoscopic surgery and open surgery

4Citations
N/AReaders
Get full text

Serum Amyloid A as an Early Marker of Infectious Complications after Laparoscopic Surgery for Colorectal Cancer

4Citations
N/AReaders
Get full text

Safety of laparoscopic surgery for colorectal cancer in patients with severe comorbidities

2Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Jabir, M. A., Brady, J. T., Wen, Y., Dosokey, E. M. G., Choi, D., Stein, S. L., … Steele, S. R. (2018). Attempting a Laparoscopic Approach in Patients Undergoing Left-Sided Colorectal Surgery Who Have Had a Previous Laparotomy: Is it Feasible? Journal of Gastrointestinal Surgery, 22(2), 316–320. https://doi.org/10.1007/s11605-017-3621-9

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 3

50%

Researcher 2

33%

Professor / Associate Prof. 1

17%

Readers' Discipline

Tooltip

Medicine and Dentistry 8

80%

Chemistry 1

10%

Engineering 1

10%

Save time finding and organizing research with Mendeley

Sign up for free