“Relaparoscopic” management of surgical complications: The experience of an Emergency Center

Giorgio Romano, Gaspare Gulotta, Antonino Agrusa, Giuseppe Di Buono, Antonino Agrusa, Giuseppe Di Buno, Silvia Di Giovanni, Giuseppe Frazzetta, Daniela Chianetta, Vincenzo Sorce, Leonardo Gulotta, Gaspare Gulotta, Giorgio Romano, Daniela Chianetta, Giuseppe Frazzetta, Silvia Di Giovanni, Vincenzo Sorce

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background/aim: Laparotomy has been the approach of choice for re-operations in patients with surgical complications. The aim of this retrospective analysis was to evaluate the feasibility and the safety of laparoscopic approach for the management of general abdominal surgery complications. Materials and methods: We report a retrospective review of 75 patients who underwent laparoscopic evaluation for postoperative complications over a 4-year period. Primary outcomes (resolution rate by exclusive laparoscopic approach, conversion rate, further surgery rate) and secondary outcomes (mortality, hospitalization, prolonged ileus, wounds problems and median operative time) were evaluated. Results: Sixty-six patients (88 %) were managed with laparoscopic approach without conversion; of these, sixty-three patients (84 %) had no more or further complications and were discharged from hospital between 4 ± 3 days after “second-look” surgery; three patients (4 %) developed postoperative complications requiring a third surgery. Nine cases (12 %) underwent conversion in open surgery after laparoscopic approach. Two elderly patients (2.7 %) died in intensive care unit, because of multi-organ failure syndrome. Median time elapsed between an intervention and another was about 2.5 ± 9.5 days. Mean operative time was 90 ± 150 min. Postoperative hospital stay was between 4.5 and 18 days. Discussion and conclusion: Laparoscopy has begun to be the preferred method to manage postoperative problems, but only few reports are available actually. Our experience in “relaparoscopic” management of surgical complications seems to suggest that laparoscopy “second look” is an effective tool after open or laparoscopic surgery for the management of postoperative complications and it may avoid diagnostic delay and further laparotomy and related problems.
Original languageEnglish
Pages (from-to)2804-2810
Number of pages7
JournalSurgical Endoscopy
Volume30
Publication statusPublished - 2016

Fingerprint

Emergencies
Laparoscopy
Operative Time
Laparotomy
Second-Look Surgery
Ileus
Intensive Care Units
Length of Stay
Hospitalization
Safety
Mortality
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

“Relaparoscopic” management of surgical complications: The experience of an Emergency Center. / Romano, Giorgio; Gulotta, Gaspare; Agrusa, Antonino; Di Buono, Giuseppe; Agrusa, Antonino; Di Buno, Giuseppe; Di Giovanni, Silvia; Frazzetta, Giuseppe; Chianetta, Daniela; Sorce, Vincenzo; Gulotta, Leonardo; Gulotta, Gaspare; Romano, Giorgio; Chianetta, Daniela; Frazzetta, Giuseppe; Di Giovanni, Silvia; Sorce, Vincenzo.

In: Surgical Endoscopy, Vol. 30, 2016, p. 2804-2810.

Research output: Contribution to journalArticle

Romano, G, Gulotta, G, Agrusa, A, Di Buono, G, Agrusa, A, Di Buno, G, Di Giovanni, S, Frazzetta, G, Chianetta, D, Sorce, V, Gulotta, L, Gulotta, G, Romano, G, Chianetta, D, Frazzetta, G, Di Giovanni, S & Sorce, V 2016, '“Relaparoscopic” management of surgical complications: The experience of an Emergency Center', Surgical Endoscopy, vol. 30, pp. 2804-2810.
Romano, Giorgio ; Gulotta, Gaspare ; Agrusa, Antonino ; Di Buono, Giuseppe ; Agrusa, Antonino ; Di Buno, Giuseppe ; Di Giovanni, Silvia ; Frazzetta, Giuseppe ; Chianetta, Daniela ; Sorce, Vincenzo ; Gulotta, Leonardo ; Gulotta, Gaspare ; Romano, Giorgio ; Chianetta, Daniela ; Frazzetta, Giuseppe ; Di Giovanni, Silvia ; Sorce, Vincenzo. / “Relaparoscopic” management of surgical complications: The experience of an Emergency Center. In: Surgical Endoscopy. 2016 ; Vol. 30. pp. 2804-2810.
@article{2a9a33c326d64f4e99d199467ecd0a34,
title = "“Relaparoscopic” management of surgical complications: The experience of an Emergency Center",
abstract = "Background/aim: Laparotomy has been the approach of choice for re-operations in patients with surgical complications. The aim of this retrospective analysis was to evaluate the feasibility and the safety of laparoscopic approach for the management of general abdominal surgery complications. Materials and methods: We report a retrospective review of 75 patients who underwent laparoscopic evaluation for postoperative complications over a 4-year period. Primary outcomes (resolution rate by exclusive laparoscopic approach, conversion rate, further surgery rate) and secondary outcomes (mortality, hospitalization, prolonged ileus, wounds problems and median operative time) were evaluated. Results: Sixty-six patients (88 {\%}) were managed with laparoscopic approach without conversion; of these, sixty-three patients (84 {\%}) had no more or further complications and were discharged from hospital between 4 ± 3 days after “second-look” surgery; three patients (4 {\%}) developed postoperative complications requiring a third surgery. Nine cases (12 {\%}) underwent conversion in open surgery after laparoscopic approach. Two elderly patients (2.7 {\%}) died in intensive care unit, because of multi-organ failure syndrome. Median time elapsed between an intervention and another was about 2.5 ± 9.5 days. Mean operative time was 90 ± 150 min. Postoperative hospital stay was between 4.5 and 18 days. Discussion and conclusion: Laparoscopy has begun to be the preferred method to manage postoperative problems, but only few reports are available actually. Our experience in “relaparoscopic” management of surgical complications seems to suggest that laparoscopy “second look” is an effective tool after open or laparoscopic surgery for the management of postoperative complications and it may avoid diagnostic delay and further laparotomy and related problems.",
author = "Giorgio Romano and Gaspare Gulotta and Antonino Agrusa and {Di Buono}, Giuseppe and Antonino Agrusa and {Di Buno}, Giuseppe and {Di Giovanni}, Silvia and Giuseppe Frazzetta and Daniela Chianetta and Vincenzo Sorce and Leonardo Gulotta and Gaspare Gulotta and Giorgio Romano and Daniela Chianetta and Giuseppe Frazzetta and {Di Giovanni}, Silvia and Vincenzo Sorce",
year = "2016",
language = "English",
volume = "30",
pages = "2804--2810",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",

}

TY - JOUR

T1 - “Relaparoscopic” management of surgical complications: The experience of an Emergency Center

AU - Romano, Giorgio

AU - Gulotta, Gaspare

AU - Agrusa, Antonino

AU - Di Buono, Giuseppe

AU - Agrusa, Antonino

AU - Di Buno, Giuseppe

AU - Di Giovanni, Silvia

AU - Frazzetta, Giuseppe

AU - Chianetta, Daniela

AU - Sorce, Vincenzo

AU - Gulotta, Leonardo

AU - Gulotta, Gaspare

AU - Romano, Giorgio

AU - Chianetta, Daniela

AU - Frazzetta, Giuseppe

AU - Di Giovanni, Silvia

AU - Sorce, Vincenzo

PY - 2016

Y1 - 2016

N2 - Background/aim: Laparotomy has been the approach of choice for re-operations in patients with surgical complications. The aim of this retrospective analysis was to evaluate the feasibility and the safety of laparoscopic approach for the management of general abdominal surgery complications. Materials and methods: We report a retrospective review of 75 patients who underwent laparoscopic evaluation for postoperative complications over a 4-year period. Primary outcomes (resolution rate by exclusive laparoscopic approach, conversion rate, further surgery rate) and secondary outcomes (mortality, hospitalization, prolonged ileus, wounds problems and median operative time) were evaluated. Results: Sixty-six patients (88 %) were managed with laparoscopic approach without conversion; of these, sixty-three patients (84 %) had no more or further complications and were discharged from hospital between 4 ± 3 days after “second-look” surgery; three patients (4 %) developed postoperative complications requiring a third surgery. Nine cases (12 %) underwent conversion in open surgery after laparoscopic approach. Two elderly patients (2.7 %) died in intensive care unit, because of multi-organ failure syndrome. Median time elapsed between an intervention and another was about 2.5 ± 9.5 days. Mean operative time was 90 ± 150 min. Postoperative hospital stay was between 4.5 and 18 days. Discussion and conclusion: Laparoscopy has begun to be the preferred method to manage postoperative problems, but only few reports are available actually. Our experience in “relaparoscopic” management of surgical complications seems to suggest that laparoscopy “second look” is an effective tool after open or laparoscopic surgery for the management of postoperative complications and it may avoid diagnostic delay and further laparotomy and related problems.

AB - Background/aim: Laparotomy has been the approach of choice for re-operations in patients with surgical complications. The aim of this retrospective analysis was to evaluate the feasibility and the safety of laparoscopic approach for the management of general abdominal surgery complications. Materials and methods: We report a retrospective review of 75 patients who underwent laparoscopic evaluation for postoperative complications over a 4-year period. Primary outcomes (resolution rate by exclusive laparoscopic approach, conversion rate, further surgery rate) and secondary outcomes (mortality, hospitalization, prolonged ileus, wounds problems and median operative time) were evaluated. Results: Sixty-six patients (88 %) were managed with laparoscopic approach without conversion; of these, sixty-three patients (84 %) had no more or further complications and were discharged from hospital between 4 ± 3 days after “second-look” surgery; three patients (4 %) developed postoperative complications requiring a third surgery. Nine cases (12 %) underwent conversion in open surgery after laparoscopic approach. Two elderly patients (2.7 %) died in intensive care unit, because of multi-organ failure syndrome. Median time elapsed between an intervention and another was about 2.5 ± 9.5 days. Mean operative time was 90 ± 150 min. Postoperative hospital stay was between 4.5 and 18 days. Discussion and conclusion: Laparoscopy has begun to be the preferred method to manage postoperative problems, but only few reports are available actually. Our experience in “relaparoscopic” management of surgical complications seems to suggest that laparoscopy “second look” is an effective tool after open or laparoscopic surgery for the management of postoperative complications and it may avoid diagnostic delay and further laparotomy and related problems.

UR - http://hdl.handle.net/10447/160306

M3 - Article

VL - 30

SP - 2804

EP - 2810

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

ER -