Is Laparoscopic Colon Surgery Appropriate in Patients who Have Had Previous Abdominal Surgery?

Laparoscopic techniques in colon surgery reduce postoperative pain, length of hospital stay, and 30-day morbidity when compared with open surgery. The objective of this study was to determine the feasibility of a laparoscopic colectomy in patients who have previously undergone abdominal surgery. We performed a retrospective, single-institution review of laparoscopic colorectal procedures for benign or malignant pathology between October 2002 and September 2008. Our analysis included 55 patients who previously had laparoscopic, open, or a combination of procedures and subsequently underwent laparoscopic colorectal surgery. We observed a 14.5 per cent conversion rate (n = 8). Of the patients who had previous open procedures (n = 48 [87.3%]), the conversion rate was 16.7 per cent. Only one patient (12.5%) who had a history of only laparoscopic surgery required conversion. The highest conversion rate in our study was from patients who underwent a left colectomy (60%, n = 3/5), which was the only statistically significant factor found for conversion. Since the emergence of laparoscopy, use in colon and rectal surgery nationwide has been poor as a result of multiple factors, including a frequent history of abdominal surgery. Our experience shows that laparoscopic colorectal surgery in patients with prior intra-abdominal surgery can be completed with an acceptable conversion rate.

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Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review

World Journal of Gastrointestinal Surgery ◽

10.4240/wjgs.v8.i7.533 ◽

2016 ◽

Vol 8 (7) ◽

pp. 533 ◽

Cited By ~ 7

Author(s):

Marleny Novaes Figueiredo ◽

Fabio Guilherme Campos ◽

Luiz Augusto D’Albuquerque ◽

Sergio Carlos Nahas ◽

Ivan Cecconello ◽

...

Keyword(s):

Systematic Review ◽

Colorectal Surgery ◽

Abdominal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Short Term ◽

Previous Abdominal Surgery

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The impact of previous open abdominal surgery on the outcome of laparoscopic colorectal surgery

Annals of Medical Research ◽

10.5455/annalsmedres.2020.05.548 ◽

2021 ◽

Vol 28 (12) ◽

pp. 2122

Author(s):

Ismail Eray ◽

Ugur Topal ◽

Orcun Yalav ◽

Kubilay Dalci ◽

Ahmet Saritas ◽

...

Keyword(s):

Colorectal Surgery ◽

Abdominal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Open Abdominal Surgery ◽

The Impact

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What Is the Relationship between Operative Time and Adverse Events after Colon and Rectal Surgery?

The American Surgeon ◽

10.1177/000313481808400524 ◽

2018 ◽

Vol 84 (5) ◽

pp. 712-716 ◽

Cited By ~ 4

Author(s):

Gabriela Poles ◽

Caitlin Stafford ◽

Todd Francone ◽

Patricia L. Roberts ◽

Rocco Ricciardi

Keyword(s):

Colorectal Surgery ◽

Adverse Events ◽

Operative Time ◽

Primary Anastomosis ◽

Multivariable Analysis ◽

Rectal Surgery ◽

Surgical Site Infections ◽

Colon And Rectal Surgery ◽

Improvement Program ◽

Tract Infections

We propose that prolonged colorectal surgery operative times are associated with increased 30-day adverse events. We identified a cohort from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from January 2005 through December 2012. Patients who underwent colectomy with primary anastomosis were selected using CPT codes. Operative time was categorized into short, average, and long based on mean operative times 61 SD. NSQIP-approved multivariate models were used to identify associations between operative time and 30-day adverse events. A total of 113,615 patients underwent colorectal resection of which 46 per cent were laparoscopic and 12 per cent were identified as long operative times. Patients with long operative procedures had 34 per cent more superficial surgical site infections, 65 per cent more organ space infections, 69 per cent more abdominal dehiscences, 44 per cent more thrombotic complications, 45 per cent more urinary tract infections, 40 per cent more returns to the operating room, and 36 per cent more prolonged lengths of stay ( P < 0.05 for all analyses). The multivariable analysis revealed an association between long operative times and increased adverse events despite adjustment for all NSQIP recommended covariates. Our results reveal increased 30-day adverse events with increased operative time. We propose that operative time may serve as a proxy for surgical complexity in colorectal surgery.

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A brief history of the American board of colon and rectal surgery

Diseases of the Colon & Rectum ◽

10.1007/bf02616970 ◽

1966 ◽

Vol 9 (3) ◽

pp. 149-158 ◽

Cited By ~ 1

Author(s):

Garnet W. Ault

Keyword(s):

Rectal Surgery ◽

Colon And Rectal Surgery ◽

History Of

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History of Colon and Rectal Surgery at Baylor University Medical Center

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2004.11927983 ◽

2004 ◽

Vol 17 (3) ◽

pp. 289-291

Author(s):

R. D. Dignan

Keyword(s):

Medical Center ◽

Rectal Surgery ◽

Colon And Rectal Surgery ◽

Baylor University ◽

History Of

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Reprint of: History of specialty training and board certification in colon and rectal surgery

Seminars in Colon and Rectal Surgery ◽

10.1053/j.scrs.2018.11.011 ◽

2018 ◽

Vol 29 (4) ◽

pp. 154-159

Author(s):

Bruce G. Wolff ◽

David J. Schoetz

Keyword(s):

Rectal Surgery ◽

Board Certification ◽

Specialty Training ◽

Colon And Rectal Surgery ◽

History Of

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Performance of surgical site infection risk prediction models in colorectal surgery: external validity assessment from three European national surveillance networks

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.163 ◽

2019 ◽

Vol 40 (9) ◽

pp. 983-990 ◽

Cited By ~ 2

Author(s):

Rebecca Grant ◽

Martine Aupee ◽

Nicolas C. Buchs ◽

Kristine Cooper ◽

Marie-Christine Eisenring ◽

...

Keyword(s):

Colorectal Surgery ◽

Risk Model ◽

Rectal Surgery ◽

Predictive Ability ◽

Specific Model ◽

Colon And Rectal Surgery ◽

National Surveillance ◽

Site Infection ◽

Surveillance Networks ◽

Routinely Collected Data

AbstractObjective:To assess the validity of multivariable models for predicting risk of surgical site infection (SSI) after colorectal surgery based on routinely collected data in national surveillance networks.Design:Retrospective analysis performed on 3 validation cohorts.Patients:Colorectal surgery patients in Switzerland, France, and England, 2007–2017.Methods:We determined calibration and discrimination (ie, area under the curve, AUC) of the COLA (contamination class, obesity, laparoscopy, American Society of Anesthesiologists [ASA]) multivariable risk model and the National Healthcare Safety Network (NHSN) multivariable risk model in each cohort. A new score was constructed based on multivariable analysis of the Swiss cohort following colorectal surgery, then based on colon and rectal surgery separately.Results:We included 40,813 patients who had undergone elective or emergency colorectal surgery to validate the COLA score, 45,216 patients to validate the NHSN colon and rectal surgery risk models, and 46,320 patients in the construction of a new predictive model. The COLA score’s predictive ability was poor, with AUC values of 0.64 (95% confidence interval [CI], 0.63–0.65), 0.62 (95% CI, 0.58–0.67), 0.60 (95% CI, 0.58–0.61) in the Swiss, French, and English cohorts, respectively. The NHSN colon-specific model (AUC, 0.61; 95% CI, 0.61–0.62) and the rectal surgery–specific model (AUC, 0.57; 95% CI, 0.53–0.61) showed limited predictive ability. The new predictive score showed poor predictive accuracy for colorectal surgery overall (AUC, 0.65; 95% CI, 0.64–0.66), for colon surgery (AUC, 0.65; 95% CI, 0.65–0.66), and for rectal surgery (AUC, 0.63; 95% CI, 0.60–0.66).Conclusion:Models based on routinely collected data in SSI surveillance networks poorly predict individual risk of SSI following colorectal surgery. Further models that include other more predictive variables could be developed and validated.

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