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Cited 23 time in webofscience Cited 26 time in scopus
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Anastomotic Leakage after Laparoscopic Protectomy can be Managed by a Minimally Invasive Approach

Authors
Joh, Yong-GeulKim, Seon-HahnHahn, Koo-YongStulberg, JonahChung, Choon-SikLee, Dong-Keun
Issue Date
Jan-2009
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
Anastomotic leakage; Rectal cancer; Laparoscopy
Citation
DISEASES OF THE COLON & RECTUM, v.52, no.1, pp.91 - 96
Indexed
SCIE
SCOPUS
Journal Title
DISEASES OF THE COLON & RECTUM
Volume
52
Number
1
Start Page
91
End Page
96
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/16322
DOI
10.1007/DCR.0b013e3181973d7f
ISSN
0012-3706
Abstract
PURPOSE: This study was designed to identify the clinical features of anastomotic leakage after laparoscopic resection of rectal cancer and to evaluate the outcomes of laparoscopic management for this problem. METHODS: Prospectively collected data were obtained from 307 patients with rectal cancer who underwent laparoscopic proctectomy and primary anastomosis. Age, sex, tumor location, tumor stage, body mass index, comorbidities, ileostomy, conversion, intraoperative blood loss, operative time, previous abdominal operation, and hospital stay were analyzed for patients with or without anastomotic leakage. Management and outcome of anastomotic leakage also were analyzed. RESULTS: Anastomotic leakage occurred in 29 patients (9.4 percent). Diverting ileostomy was initially fashioned in 65 patients (21.2 percent). Leakage was related to young age, male sex, lower tumor location, and longer operation time. Ten patients (34.5 percent) were successfully managed with conservative treatment. Seventeen patients (58.6 percent) were managed via a laparoscopic approach. Open surgery was performed in two patients who showed diffuse fecal soiling or had previous conversion, respectively. There was no mortality. CONCLUSIONS: When leakage occurs, laparotomy or colostomy is not needed routinely. For surgical intervention, the abdominal cavity should be explored first by laparoscopic visualization because the majority of patients can be successfully managed with laparoscopy and ileostomy.
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2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles

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