Postoperative complications of laparoscopic-assisted colectomy.
BACKGROUND
This study was performed to prospectively assess the complications of 118 consecutive patients who underwent laparoscopic assisted colorectal resections.


METHODS
The variables included were: indication for surgery, type of resection, duration of operation, duration of postoperative ileus, length of hospital stay, port-site recurrence, and complications in relation to the laparoscopic technique.


RESULTS
118 Laparoscopic-assisted procedures were performed between July 1992 and October 1995. Surgical indications were: 106 patients for colonic malignancy, six for diverticulitis, two for Crohn's disease, two for benign polyps, one for endometriosis, and one for ischemic colitis. Fifteen patients required conversion to open techniques for completion of the operations (12.7%). The mean operating time was 168.8 min. The amount of operative blood loss was 98 ml. The mean time for passing flatus was 36 +/- 16 h. Mean postoperative stay was 5.4 (range 3-13) days. Eight patients (6.8%) sustained complications: four unrelated to laparoscopy (three wound infection, one anastomotic leak); and four complications related to the laparoscopic approach: one small-bowel obstruction, one trocar injury, one rotation of the anastomosis, and one misdiagnosed synchronous adenocarcinoma.


CONCLUSIONS
We suggest that with the development of improved technical devices and more experience, the indications for laparoscopic colectomy should continue to expand. The low incidence of infectious complications suggests an important role for the laparoscopic approach to colorectal surgery.
Lacy
A M
AM
Department of Surgery, Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
García-Valdecasas
J C
JC
Delgado
S
S
Grande
L
L
Fuster
J
J
Tabet
J
J
Ramos
C
C
Piqué
J M
JM
Cifuentes
A
A
Visa
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003108:Colonic Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate