Laparoscopic "second-look" in the management of mesenteric ischemia.
Mesenteric ischemia is a major cause of mortality in surgery. Despite the advances in medicine, considerable number of patients undergoes reoperations for a better assessment of intestinal viability. Although great majority of these second-look operations are "negative explorations," progressive nature of this devastating disease pushes surgeons to re-explore the abdomen. This study compares open and laparoscopic "second-look" procedures in patients with mesenteric ischemia. In the first group (n = 41), abdomen was closed and second-look laparotomy was performed to 23 patients. In the second group (n = 36), a 10-mm trocar was inserted before closing the abdomen and second-look intervention was performed by a telescope to 23 patients. Sixteen of relaparotomies in the first group (70%) revealed nothing and were unnecessary. Two patients (8%) in the laparoscopy group needed re-resection while 20 patients (87%) were rescued from unnecessary laparotomies. Conclusively, patients with mesenteric ischemia are "ill enough" to deserve the "minimal invasion" spirit of laparoscopic surgery.
Department of Surgery, School of Medicine, Gazi University, Ankara, Turkey. zanadol@yahoo.com
A Ziya
AZ
Anadol
Emin
E
Ersoy
Ferit
F
Taneri
Ercüment H
EH
Tekin
D015897:Comorbidity; D018450:Disease Progression; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000601:surgery*; D007813:Laparotomy; D008643:Mesentery / Q000098:blood supply*; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods*; D017131:Thrombectomy