title: Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery.
abstract: OBJECTIVE
  The aim of this study is to evaluate the safety and feasibility of laparoscopic reintervention compared with open surgery in patients with anastomotic leakage after minimally invasive colorectal surgery.
  
  
  METHODS
  Between January 2008 and December 2012, 77 patients who required surgical reintervention for anastomotic leakage following minimally invasive colorectal surgery were included in this study. Data on the patients' demographics, operative management, morbidity, hospital stay, and mortality were analyzed for differences based on whether they received laparoscopic or open surgery.
  
  
  RESULTS
  Sixteen patients underwent open surgery following laparoscopy, and 61 patients received laparoscopic reintervention following laparoscopy. The conversion rate was 8.2 % (5/61). The median total hospital stay following reintervention was significantly shorter for laparoscopic surgery (16.0 days, range 9-117 days) than for open surgery (35.5 days, range 10-135 days, p < 0.001). The postoperative 30-day morbidity rate, including wound dehiscence (25.0 vs 3.3 %, p = 0.015) and intra-abdominal infection (31.3 vs 6.6 %, p = 0.016), was lower in the laparoscopic surgery group than in the open surgery group. The rate of stoma closure was lower in the open surgery group than in the laparoscopic surgery group (43.8 vs 80.5 %, p < 0.001). There was one in-hospital mortality in the open surgery group.
  
  
  CONCLUSIONS
  Laparoscopic reintervention for anastomotic leakage following minimally invasive colorectal surgery is associated with a shorter hospital stay, fewer postoperative complications, and a higher stoma closure rate than open surgery. Laparoscopic reintervention for anastomotic leakage is feasible and safe.
authors: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
authors: Chul Min
authors: CM
authors: Lee
authors: Jung Wook
authors: JW
authors: Huh
authors: Seong Hyeon
authors: SH
authors: Yun
authors: Hee Cheol
authors: HC
authors: Kim
authors: Woo Yong
authors: WY
authors: Lee
authors: Yoon Ah
authors: YA
authors: Park
authors: Yong Beom
authors: YB
authors: Cho
authors: Ho-Kyung
authors: HK
authors: Chun
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D002681:China / Q000453:epidemiology; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000379:methods; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome