title: Intraoperative colonoscopy for anastomosis assessment in laparoscopically assisted left-sided colon resection: is it worthwhile?
abstract: BACKGROUND
  The aim of our study was to evaluate the use of intraoperative colonoscopy in laparoscopically assisted left-sided colon resection for the assessment of anastomosis.
  
  
  METHODS
  All consecutive laparoscopically assisted left-sided colon resections performed at our department between May 2001 and February 2006 were included in this study. After colon resection and reanastomosis, an intraoperative colonoscopy was performed to detect anastomosis risk.
  
  
  RESULTS
  A total of 122 patients were enrolled in this study. In 73 patients (59.84%), the anastomosis was checked via colonoscopy (the study group, (SG), whereas the control group (CG) consisted of 49 (40.16%) patients without colonoscopy. Of the 122 patients, 65 (53.28%) underwent a laparoscopically assisted sigmoid resection, 45 (36.89%) a laparoscopically assisted sigmoid rectum resection, 4 (3.28%) a laparoscopically assisted anterior rectum resection, and 8 (6.56%) a laparoscopically assisted left hemicolectomy. In the study group, 5 (6.85%) anastomotic leakages were intraoperatively detected and oversewn. A total of 6 (4.92%) anastomotic leakages occurred in the early postoperative period (SG: 4 [5.47%] vs. CG: 2 [4.08%]; P = 0.541).
  
  
  CONCLUSIONS
  Intraoperative evaluation of anastomosis prevents early anastomotic insufficiency because intraoperative identification of leaks allows for repair during surgery. Nevertheless, a certain rate of anastomotic dehiscence occurs in every kind of colon resection. The sometimes increased rate of dehiscence in laparoscopic-assisted colon resection can be reduced by intraoperative colonoscopy.
authors.affiliation: Department of General and Transplant Surgery Innsbruck Medical University Hospital, Innsbruck, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Lanthaler
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Reinhard
authors.initials: R
authors.lastname: Mittermair
authors.forename: Dietmar
authors.initials: D
authors.lastname: Ofner
authors.forename: Hermann
authors.initials: H
authors.lastname: Nehoda
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000601:surgery*; D012809:Colon, Sigmoid / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000601:surgery; D043963:Diverticulosis, Colonic / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000601:surgery; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery