Gilberto Lozano Dubernard, MD, FACS, Ramon Gil-Ortiz, MD, Gustavo Cruz-Santiago, MD, Bernardo Rueda-Torres, MD, Javier Lopez-Gutierrez, MD, FACS. Hospital Angeles Del Pedregal
INTRODUCTION: To assess the feasibility of a single-stage colorectal laparoscopic re intervention without ostomy. Colonic Laparoscopic interventions on patients that previously underwent a minimally invasive procedure, constitutes the current boundary in the management of the acute colorectal pathology. That includes, patients with fecal peritonitis due to diverting procedures already treated surgically.The outcome of our patients could significantly improve if the surgical procedure is performed in one time, with no stoma.
METHOD AND PROCEDURES: From September 1995 to June 2016, one hundred thirty-two patients underwent colorectal laparoscopic surgery. Five of these patients developed complications: three perforations due to colonoscopy and two due to dehiscence of the anastomosis. These five patients underwent a second laparoscopic procedure that included resection and anastomosis. No stoma required.
RESULTS: All five patients underwent a second laparoscopic procedure due to an anastomosis leak. No stoma was required. The procedure consisted on resection of the previous anastomosis, re anastomosis, abdominal lavage, aspiration and drains placement. All of them supported with parenteral nutrition. There were no surgical complications. Only one patient developed pneumonic symptoms that were solved.
CONCLUSION: The reported results, regarding no conversion rate, nor mortality, on our series of patients, suggest that single stage laparoscopic re intervention is feasible, despite fecal peritonitis
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85227
Program Number: P243
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster