Predicting conversion to open surgery in laparoscopic colorectal resections

2000 ◽  
Vol 14 (12) ◽  
pp. 1114-1117 ◽  
Author(s):  
C. M. Schlachta ◽  
J. Mamazza ◽  
P. A. Seshadri ◽  
M. O. Cadeddu ◽  
E. C. Poulin
Keyword(s):  
Open Surgery ◽  
Conversion To Open Surgery ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections

scholarly journals Primary Outcome of Laparoscopic Colorectal Resections in a Northern Finnish Hospital: A Single Center Study

2018 ◽  
Vol 108 (2) ◽  
pp. 137-143
Author(s):  
H. Huhta ◽  
S. Vuolio ◽  
I. Typpö ◽  
A. Rahko ◽  
K. Suokanerva ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Open Surgery ◽  
Primary Outcome ◽  
Laparoscopic Colorectal Surgery ◽  
Surgical Complication ◽  
Hospital Data ◽  
Patient Registries ◽  
American Society ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections

Background and Aims: Over the past decades, laparoscopic colorectal surgery has become widely used for various indications. Large multicenter studies have demonstrated that laparoscopy has clear advantages over open surgery. Compared to open procedures, laparoscopy decreases perioperative blood loss, post-operative pain, and hospitalization time, but provides equivalent long-term oncological and surgical results. Most studies have been conducted in high-volume institutions with selected patients, which may have influenced the reported outcome of laparoscopy. Here, we investigated the primary outcome of all laparoscopic colorectal resections performed between 2005 and 2015 in a low-volume center. Materials and Methods: This retrospective study included bowel resections performed between 2005 and 2015 in the Lapland Central Hospital. Data were retrieved from electronic patient registries, and all operations that began as a laparoscopy were included. Patient records were investigated to determine the primary surgical outcome and possible complications within the first 30 days after surgery. Results: During 2005–2015, 385 laparoscopic colorectal resections were performed. Indications included benign (n = 166 patients, 43.1%) and malignant lesions (n = 219 cases, 56.9%). The median patient age was 68 years, and 50.4% were male. The median American Society of Anesthesiologist score was III, and 48.5% of patients had an American Society of Anesthesiologist class of III or IV. The median hospital stay after surgery was 6 days (interquartile range: 3.8). The conversion rate to open surgery rate was 13%. The total surgical complication rate was 24.2%, and re-operation was required in 11.2% of patients. A total of 26 patients had anastomotic leakage, of which 16 required re-operations. The 30-day mortality was 0.8%. Conclusion: Our results showed that laparoscopic colorectal surgery in a peripheral hospital resulted in primary outcome rates within the range of those reported in previous multicenter trials. Therefore, the routine use of laparoscopic colorectal resections with high-quality outcome is feasible in small and peripheral surgical units.

scholarly journals Compliance with enhanced recovery protocols in elderly patients undergoing colorectal resection

2018 ◽  
Vol 100 (7) ◽  
pp. 570-579 ◽  
Author(s):  
S Hallam ◽  
F Rickard ◽  
N Reeves ◽  
D Messenger ◽  
J Shabbir
Keyword(s):  
Multivariate Analysis ◽  
Colorectal Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Enhanced Recovery ◽  
Age Groups ◽  
Conversion To Open Surgery ◽  
Delayed Discharge ◽  
Significant Difference ◽  
Colorectal Resections

Introduction Enhanced recovery after surgery (ERAS) is associated with reduced length of stay (LOS) and improved outcomes in colorectal surgery. It is unclear whether ERAS can be safely implemented in elderly patients undergoing complex colorectal resections. The aim of this study was to evaluate the feasibility of ERAS in patients of all ages undergoing colorectal surgery. Methods A prospective database of a consecutive series of patients undergoing colorectal resections with ERAS between August 2012 and December 2014 was evaluated. Patients were divided into four age groups. Outcomes studied were compliance with ERAS elements, LOS, morbidity and mortality. Results Of the 294 patients in the study cohort, 79 were <60 years, 81 were 60–69 years, 86 were 70–79 years and 48 were ≥80 years of age. There was no significant difference between age groups in compliance with ERAS elements. Age was not predictive of delayed discharge (LOS >6 days) or morbidity. Factors that were predictive of delayed discharge on multivariate analysis were open surgery (odds ratio [OR]: 2.23, p=0.003), conversion to open surgery (OR: 3.23, p=0.017), stoma formation (OR: 2.10, p=0.019) and chronic obstructive pulmonary disease (OR: 4.12, p=0.038). Factors predictive of morbidity on multivariate analysis comprised conversion to open surgery (OR: 7.72, p=0.004), high creatinine (OR: 1.03 per unit increase in creatinine, p=0.008) and stoma education (OR: 0.31, p=0.030). Conclusions ERAS can be successfully implemented in older patients. There was equal compliance with the ERAS programme across the four age groups and no significant effect of age on LOS or morbidity.

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

scholarly journals Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity

2016 ◽  
Vol 59 (4) ◽  
pp. 262-267 ◽  
Author(s):  
Adina E. Feinberg ◽  
Ahmad Elnahas ◽  
Shaheena Bashir ◽  
Michelle C. Cleghorn ◽  
Fayez A. Quereshy
Keyword(s):  
Perioperative Morbidity ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections

Emergency Cholecystectomy for Patients on Antiplatelet Therapy

2017 ◽  
Vol 83 (5) ◽  
pp. 486-490 ◽  
Author(s):  
Keiichi Akahoshi ◽  
Takanori Ochiai ◽  
Ayumi Takaoka ◽  
Takuya Kitamura ◽  
Daisuke Ban ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Acute Cholecystitis ◽  
Antiplatelet Therapy ◽  
Open Surgery ◽  
Massive Hemorrhage ◽  
Intraoperative Blood Loss ◽  
Local Inflammation ◽  
Conversion To Open Surgery ◽  
Difficult Decision ◽  
Emergency Cholecystectomy

The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACTis still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014. Treatment outcomes among 13 patients who underwent cholecystectomy without discontinuing APT (the cAPT group), 11 patients who discontinued APT and ACT (the D group), and 89 patients who did not receive preoperative APT and/or ACT (the No APT group) were compared. There were no significant differences in intraoperative blood loss, conversion to open surgery, and bleeding-related complications. However, the incidence of intraoperative blood transfusion was higher in the cAPT group (P = 0.04). They presented with severe local inflammation; thus, it was difficult to stop bleeding from the gallbladder bed. Hemostatic tools for liver surgery were used to control bleeding. Emergency cholecystectomy was tolerable for patients with acute cholecystitis while continuing APT. However, in case of severe local inflammation, there is a greater risk for massive hemorrhage.

Single-port laparoscopic colorectal resections in obese patients are as safe and effective as conventional laparoscopy

2014 ◽  
Vol 28 (10) ◽  
pp. 2884-2889 ◽  
Author(s):  
Erman Aytac ◽  
Matthias Turina ◽  
Emre Gorgun ◽  
Luca Stocchi ◽  
Feza H. Remzi ◽  
...  
Keyword(s):  
Single Port ◽  
Conventional Laparoscopy ◽  
Obese Patients ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections

Laparoscopic Colorectal Resections

2014 ◽  
Vol 57 (7) ◽  
pp. 869-874 ◽  
Author(s):  
Carlos A. Vaccaro ◽  
Gustavo L. Rossi ◽  
Guillermo Ojea Quintana ◽  
Enrique R. Soriano ◽  
Hernan Vaccarezza ◽  
...  
Keyword(s):  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections
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