Skip to main content
SpringerLink
Log in
Book cover

Minimally Invasive Acute Care Surgery pp 97–105Cite as

Laparoscopic Re-exploration for Colorectal Surgery Complications

  • Chapter
  • First Online:

  • 609 Accesses

Abstract

Minimally invasive surgery is the standard practice for many elective colorectal cases. Emergency laparoscopic colon surgery is gaining momentum and has been found to be safe and technically feasible [1]. A systematic review demonstrated earlier return of gastrointestinal function, shorter length of hospital stay, fewer complications, and lower mortality rates in those undergoing laparoscopic compared to open colectomy [2]. With advanced minimally invasive surgery expertise, management of surgical complications following colorectal surgery, such as anastomotic leak, rectal stump blowout, and small bowel volvulus, can be approached laparoscopically. The patient’s hemodynamic function should be able to tolerate the physiologic effects of CO2 pneumoperitoneum [3, 4]. Patients with abdominal compartment syndrome, poor lung compliance, bradyarrhythmias, or hemodynamic instability will not tolerate the increased intra-abdominal pressure, decreased functional residual capacity of the lung, or vagal stimulation induced by stretching of the peritoneum on insufflation that are associated with laparoscopy [4, 5]. The purpose of this chapter is to highlight the clinical and technical aspects of laparoscopic management of the common complications following colorectal surgery.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Key References

  1. Titu LV, Zafar N, Phillips SM, Greenslade GL, Dixon AR. Emergency laparoscopic surgery for complicated diverticular disease. Color Dis. 2009;11(4):401–4.

    Article  CAS  Google Scholar 

  2. Harji DP, Griffiths B, Burke D, Sagar PM. Systematic review of emergency laparoscopic colorectal resection. Br J Surg. 2014;101(1):e126–33.

    Article  CAS  PubMed  Google Scholar 

  3. McLaughlin JG, Scheeres DE, Dean RJ, Bonnell BW. The adverse hemodynamic effects of laparoscopic cholecystectomy. Surg Endosc. 1995;9(2):121–4.

    Article  CAS  PubMed  Google Scholar 

  4. Dexter SP, Vucevic M, Gibson J, McMahon MJ. Hemodynamic consequences of high- and low-pressure capnoperitoneum during laparoscopic cholecystectomy. Surg Endosc. 1999;13(4):376–81.

    Article  CAS  PubMed  Google Scholar 

  5. Myles PS. Bradyarrhythmias and laparoscopy: a prospective study of heart rate changes with laparoscopy. Aust N Z J Obstet Gynaecol. 1991;31(2):171–3.

    Article  CAS  PubMed  Google Scholar 

  6. Kingham TP, Pachter HL. Colonic anastomotic leak: risk factors, diagnosis, and treatment. J Am Coll Surg. 2009;208(2):269–78.

    Article  PubMed  Google Scholar 

  7. Peel AL, Taylor EW. Proposed definitions for the audit of postoperative infection: a discussion paper. Surgical Infection Study Group. Ann R Coll Surg Engl. 1991;73(6):385–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Mirnezami A, Mirnezami R, Chandrakumaran K, Sasapu K, Sagar P, Finan P. Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis. Ann Surg. 2011;253(5):890–9.

    Article  PubMed  Google Scholar 

  9. Frasson M, Flor-Lorente B, Rodriguez JL, et al. Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, National Study with 3193 patients. Ann Surg. 2015;262(2):321–30.

    Article  PubMed  Google Scholar 

  10. Murray AC, Chiuzan C, Kiran RP. Risk of anastomotic leak after laparoscopic versus open colectomy. Surg Endosc. 2016;30(12):5275–82.

    Article  PubMed  Google Scholar 

  11. van der Pas MH, Haglind E, Cuesta MA, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14(3):210–8.

    Article  PubMed  Google Scholar 

  12. Thomas MS, Margolin DA. Management of colorectal anastomotic leak. Clin Colon Rectal Surg. 2016;29(2):138–44.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bhangu A, Singh P, Fitzgerald JE, Slesser A, Tekkis P. Postoperative nonsteroidal anti-inflammatory drugs and risk of anastomotic leak: meta-analysis of clinical and experimental studies. World J Surg. 2014;38(9):2247–57.

    Article  PubMed  Google Scholar 

  14. Van Koughnett JA, Wexner SD. Surgery. NSAIDs and risk of anastomotic leaks after colorectal surgery. Nat Rev Gastroenterol Hepatol. 2014;11(9):523–4.

    Article  PubMed  Google Scholar 

  15. Rutegard M, Westermark S, Kverneng Hultberg D, Haapamaki M, Matthiessen P, Rutegard J. Non-steroidal anti-inflammatory drug use and risk of anastomotic leakage after anterior resection: a protocol-based study. Dig Surg. 2016;33(2):129–35.

    Article  CAS  PubMed  Google Scholar 

  16. Ricciardi R, Roberts PL, Marcello PW, Hall JF, Read TE, Schoetz DJ. Anastomotic leak testing after colorectal resection: what are the data? Arch Surg. 2009;144(5):407–11. discussion 411–402.

    Article  PubMed  Google Scholar 

  17. Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147(3):339–51.

    Article  PubMed  Google Scholar 

  18. Lee CM, Huh JW, Yun SH, et al. Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery. Surg Endosc. 2015;29(4):931–6.

    Article  PubMed  Google Scholar 

  19. Annese V, Duricova D, Gower-Rousseau C, Jess T, Langholz E. Impact of new treatments on hospitalisation, surgery, infection, and mortality in IBD: a focus paper by the epidemiology committee of ECCO. J Crohns Colitis. 2016;10(2):216–25.

    Article  PubMed  Google Scholar 

  20. Gu J, Stocchi L, Remzi F, Kiran RP. Intraperitoneal or subcutaneous: does location of the (colo)rectal stump influence outcomes after laparoscopic total abdominal colectomy for ulcerative colitis? Dis Colon Rectum. 2013;56(5):615–21.

    Article  PubMed  Google Scholar 

  21. Carter FM, McLeod RS, Cohen Z. Subtotal colectomy for ulcerative colitis: complications related to the rectal remnant. Dis Colon Rectum. 1991;34(11):1005–9.

    Article  CAS  PubMed  Google Scholar 

  22. Kyle SM, Steyn RS, Keenan RA. Management of the rectum following colectomy for acute colitis. Aust N Z J Surg. 1992;62(3):196–9.

    Article  CAS  PubMed  Google Scholar 

  23. Wojdemann M, Wettergren A, Hartvigsen A, Myrhoj T, Svendsen LB, Bulow S. Closure of rectal stump after colectomy for acute colitis. Int J Color Dis. 1995;10(4):197–9.

    Article  CAS  Google Scholar 

  24. McKee RF, Keenan RA, Munro A. Colectomy for acute colitis: is it safe to close the rectal stump? Int J Color Dis. 1995;10(4):222–4.

    Article  CAS  Google Scholar 

  25. Trickett JP, Tilney HS, Gudgeon AM, Mellor SG, Edwards DP. Management of the rectal stump after emergency sub-total colectomy: which surgical option is associated with the lowest morbidity? Color Dis. 2005;7(5):519–22.

    Article  CAS  Google Scholar 

  26. Ng RL, Davies AH, Grace RH, Mortensen NJ. Subcutaneous rectal stump closure after emergency subtotal colectomy. Br J Surg. 1992;79(7):701–3.

    Article  CAS  PubMed  Google Scholar 

  27. Karch LA, Bauer JJ, Gorfine SR, Gelernt IM. Subtotal colectomy with Hartmann’s pouch for inflammatory bowel disease. Dis Colon Rectum. 1995;38(6):635–9.

    Article  CAS  PubMed  Google Scholar 

  28. Dan AVCAM N., Faria J., Gordon P., Boutros M. Distal stump leaks following a Hartmann’s procedure: an ACS-NSQIP study of risks and outcomes [ABSTRACT]. ASCRS 2017 Annual Scientific Meeting. 2017.

    Google Scholar 

  29. Schein M, Kopelman D, Nitecki S, Hashmonai M. Management of the leaking rectal stump after Hartmann’s procedure. Am J Surg. 1993;165(2):285–7.

    Article  CAS  PubMed  Google Scholar 

  30. Mullen MG, Cullen JM, Michaels AD, Hedrick TL, Friel CM. Ileal j-pouch volvulus following total proctocolectomy for ulcerative colitis. J Gastrointest Surg. 2016;20(5):1072–3.

    Article  PubMed  Google Scholar 

  31. Patel S, Salotera G, Gurjar S, Hewes J, Ahmed I, Andrews B. Ileo-anal pouch necrosis secondary to small bowel volvulus: a case report. World J Emerg Surg. 2008;3:18.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Catalano O. Small bowel volvulus following ileal pouch-anal anastomosis: CT demonstration. Eur J Radiol. 1996;23(2):115–7.

    Article  CAS  PubMed  Google Scholar 

  33. Warren C, O’Donnell ME, Gardiner KR, Irwin T. Successful management of ileo-anal pouch volvulus. Color Dis. 2011;13(1):106–7.

    Article  CAS  Google Scholar 

  34. Arima K, Watanabe M, Iwatsuki M, et al. Volvulus of an ileal pouch-rectal anastomosis after subtotal colectomy for ulcerative colitis: report of a case. Surg Today. 2014;44(12):2382–4.

    Article  PubMed  Google Scholar 

  35. Sherman J, Greenstein AJ, Greenstein AJ. Ileal j pouch complications and surgical solutions: a review. Inflamm Bowel Dis. 2014;20(9):1678–85.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, McGill University Health Centre, Montreal, QC, Canada

    Nathalie Wong-Chong

  2. Department of Colon & Rectal Surgery, McGill University Health Centre, Montreal, QC, Canada

    A. Sender Liberman

Authors
  1. Nathalie Wong-Chong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Sender Liberman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Sender Liberman .

Editor information

Editors and Affiliations

  1. Director of Acute Care Surgery, Montreal General Hospital, Associate Director, Trauma Program Departments of Surgery and Critical Care, McGill University Health Center, Montreal, Québec, Canada

    Kosar A. Khwaja

  2. Chief Division of Acute Care Surgery, Acute Care Surgery, Fellowship, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA

    Jose J. Diaz

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wong-Chong, N., Liberman, A.S. (2018). Laparoscopic Re-exploration for Colorectal Surgery Complications. In: Khwaja, K., Diaz, J. (eds) Minimally Invasive Acute Care Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-64723-4_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64723-4_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64721-0

  • Online ISBN: 978-3-319-64723-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation