Feasibility of Emergency Laparoscopic Reoperations for Complications after Laparoscopic Surgery for Colorectal Cancer

ABSTRACT

PURPOSE: Laparoscopic surgery (LS) is an alternative to colorectal cancer surgery. Little evidence supports LS for emergency reoperation after laparoscopic colorectal surgery. The aim of this study was to assess perioperative outcomes of LS as an emergency reoperation for early complications after LS for colorectal cancer. METHODS: From June 2006 through December 2016, 732 consecutive patients underwent elective LS for colorectal cancer at Kyung Hee University Hospital, Seoul, Korea. Among these patients, we retrospectively reviewed data on those who received emergency laparoscopic reoperations for complications within 30 days after surgery. Variables associated with perioperative outcomes were analyzed. RESULTS: After exclusion of 50 patients (6.8%) who needed conversion to open surgery during LS, 79 of 682 patients (11.6%) received reoperation for complications, recurrence, and other benign diseases. Among them, 22 patients underwent emergency laparoscopic reoperation for early complications. Mean age of the patients was 62 years, and most underwent low anterior resection as a primary operation (n=17, 77.3%). Anastomotic leakage was the most common reason for reoperation (n=14, 63.6%). Postoperative complication occurred in 6 patients (27.3%), but none required further surgical intervention. Patients had first bowel movements at 2.8 days after reoperation, and length of hospital stay was 17.2 days after reoperation. CONCLUSION: Laparoscopic reoperation showed acceptable outcomes. LS as a reoperation for complications seemed to be feasible after LS for colorectal cancer.