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

Antonino Agrusa, Giuseppe Di Buono, Giorgio Romano, Gaspare Gulotta, 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 journalArticlepeer-review

33 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

All Science Journal Classification (ASJC) codes

  • Surgery

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