title: A systematic review of the role of re-laparoscopy in the management of complications following laparoscopic colorectal surgery.
abstract: The benefits of laparoscopic versus open surgery for patients with both benign and malignant colorectal disease have been well established. Re-laparoscopy in patients who develop complications following laparoscopic colorectal surgery has recently been reported by some groups and the aim of this systematic review was to summarise this literature. A literature search of PubMed, Medline and EMBASE identified a total of 11 studies that reported laparoscopic re-intervention for complications in 187 patients following laparoscopic colorectal surgery. The majority of these patients required re-intervention in the immediate postoperative period (i.e. less than seven days). Anastomotic leakage was the commonest complication requiring re-laparoscopy reported (n = 139). Other complications included postoperative hernia (n = 12), bleeding (n = 9), adhesions (n = 7), small bowel obstruction (n = 4), colonic ischaemia (n = 4), bowel and ureteric injury (n = 3 respectively) and colocutaneous fistula (n = 1). Ninety-seven percent of patients (n = 182) who underwent re-laparoscopy had their complications successfully managed by re-laparoscopy, maintaining the benefits of the laparoscopic approach and avoiding a laparotomy. We conclude that re-laparoscopy for managing complications following laparoscopic colorectal surgery appears to be safe and effective in highly selected patients.
authors.affiliation: Department of Surgery, The Adelaide & Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: kahhoong_chang@yahoo.co.uk.
authors.forename: K H
authors.initials: KH
authors.lastname: Chang
authors.affiliation: Department of Surgery, The Adelaide & Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: mikebourkecork@yahoo.co.uk.
authors.forename: M G
authors.initials: MG
authors.lastname: Bourke
authors.affiliation: Department of Surgery, The Adelaide & Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: dara_kav@hotmail.com.
authors.forename: D O
authors.initials: DO
authors.lastname: Kavanagh
authors.affiliation: Department of Surgery, The Adelaide & Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: paulcneary@msn.com.
authors.forename: P C
authors.initials: PC
authors.lastname: Neary
authors.affiliation: Department of Surgery, The Adelaide & Meath Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. Electronic address: james.oriordan@amnch.ie.
authors.forename: J M
authors.initials: JM
authors.lastname: O'Riordan
mesh_terms: D003108:Colonic Diseases / Q000601:surgery; D003107:Colorectal Surgery / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery*; D011184:Postoperative Period; D012002:Rectal Diseases / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Colorectal surgery; Complications; Laparoscopy; Re-laparoscopy