title: Laparoscopic reintervention for anastomotic leakage after primary laparoscopic colorectal surgery.
abstract: BACKGROUND
  Anastomotic leakage is associated with high morbidity and mortality rates. The aim of this study was to assess the potential benefits of a laparoscopic reintervention for anastomotic leakage after primary laparoscopic surgery.
  
  
  METHODS
  Between January 2003 and January 2006, ten patients who had laparoscopic colorectal resection and later developed anastomotic leakage had a laparoscopic reintervention. A second group included 15 patients who had relaparotomy after primary open surgery.
  
  
  RESULTS
  Patient characteristics were comparable in the two groups. The median time from first operation to reintervention was 6 days in both groups. There were no conversions. The intensive care stay was shorter in the laparoscopic group (1 versus 3 days; P = 0.002). Resumption of a normal diet (median 3 versus 6 days; P = 0.031) and first stoma output (2 versus 3 days; P = 0.041) occurred earlier in the laparoscopic group. The postoperative 30-day morbidity rate was lower (four of ten patients versus 12 of 15; P = 0.087) and hospital stay was shorter (median 9 versus 13 days; P = 0.058) in the laparoscopic group. No patient developed incisional hernia in the laparoscopic group compared with five of 15 in the open group (P = 0.061).
  
  
  CONCLUSIONS
  These data suggest that laparoscopic reintervention for anastomotic leakage after primary laparoscopic surgery is associated with less morbidity, faster recovery and fewer abdominal wall complications than relaparotomy.
authors: Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors: J
authors: J
authors: Wind
authors: A G
authors: AG
authors: Koopman
authors: M I
authors: MI
authors: van Berge Henegouwen
authors: J F M
authors: JF
authors: Slors
authors: D J
authors: DJ
authors: Gouma
authors: W A
authors: WA
authors: Bemelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods; D003107:Colorectal Surgery / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D016896:Treatment Outcome