title: Systematic review of the feasibility of laparoscopic reoperation for early postoperative complications following colorectal surgery.
abstract: BACKGROUND
  Returning to the operating theatre for management of early postoperative complications after colorectal surgery is an important key performance indicator. Laparoscopic surgery has benefits that may be useful in surgical emergencies. This study explored the evidence for the advantages of laparoscopic reoperation.
  
  
  METHODS
  A systematic review was performed to identify publications reporting the outcomes of laparoscopy as a mode of reoperation for the management of early postoperative complications of colorectal surgery. The main outcomes examined were 30-day mortality, 30-day morbidity, length of hospital stay, second reoperation rate, ICU admission and stoma formation at reoperation.
  
  
  RESULTS
  After screening 3657 citations, ten non-randomized cohort studies were identified (1137 reoperations). Laparoscopic reoperation was equivalent to or better than open reoperation, with lower rates of 30-day mortality (0-4·4 versus 0-13·6 per cent), 30-day morbidity (6-40 versus 30-80 per cent), length of stay (mean(s.d.) 15·8(2·8) versus 29·1(14·5) days), ICU admission and duration of stay in the ICU. Anastomotic leak was the most common indication, after which more patients received a defunctioning loop stoma instead of an end stoma at laparoscopic than open reoperation.
  
  
  CONCLUSIONS
  Laparoscopic reoperation is feasible in selected patients, with the advantages of improved short-term outcomes.
authors.affiliation: Academic Colorectal Unit, Sydney Medical School - Concord, Sydney, Australia.
authors.forename: D B
authors.initials: DB
authors.lastname: Wright
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: C E
authors.initials: CE
authors.lastname: Koh
authors.affiliation: Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy / Q000379:methods; D061887:Conversion to Open Surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D058106:Wound Closure Techniques