Yi Chang Chen, Yuan Yao Tsai, Yu Chun Huang, Shen Ji Chang, Tao Wei Ke, Hung-Change Chen, Huei Ming Wang, William Tzu-Liang Chen. Department of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan
Background: Minimal invasive surgery has been well established in the elective colorectal surgery and it has been proven better clinical outcome compared with open surgery. In the emergent setting, laparoscope is used mostly in the colecystectomy ,appendectomy but laparoscopic emergent colorectal surgery is limited for it`s complexity and difficulity. The aim of this study was to envaluate the feasibility of laparoscopic emergent colorectal surgery.
Methods: This study is prospective collected,observational single center study of patients undergoing laparoscopic emergent colorectal surgery from 2011 to 2016. The patient demographics, surgery indication and detail, complication, clinical outcome and hospital stay were collected and analyzed.
Results: There are total 130 emergent colorectal operations and 57 patients were managed with minimal invasive method. Among these laparoscopic emergent surgery, there are 33 male patients and 24 female patients. Mean age of the patients was 63.8 years (Range 31-89years). The main indication for operation: perforation 49.1%(28/57),leakage after elective colorectal surgery 42.1% (24/57),obstruction 3.5%(2/57),ischemia colitis 3.5%(2/57,),bleeding 1.8%(1/57). There are 19 cases in ASA 2, 32 cases in ASA 3, 6 cases in ASA 4. The qSOFA score for sepsis:23 cases was 0, 28 cases was 1, 5 cases was 2, 1 case was 3.
There are 27 cases undergoing laparoscopic lavage with diverting stomy, 15 cases were Hartmann procedure, 5 cases were anterior resection,4 cases were right hemicolectomy, 3 cases were perforation repair, 3 cases were redo anastomosis. There are 6 cases coversion to open method including 3 cases were due to bowel adhesion,2 cases were due to bowel distension,1 case was due to severe shock status. Mean operative time is 180.3 minutes.
The overall mortality rate was 5.2% and major complication rate (Clavien-Dindo grade above 2) was 24.5%.Re-operation rate was 15.7%. The mean hospital stay was 17.1 days.
Conclusions: This study presents evidence of an initially clinical outcome in emergent laparoscopic colorectal suregry . In the absence of large case series, the benefits of a laparoscopic approach should befall to at least a minority of these patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86775
Program Number: P229
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster