POSTOPERATIVE COMPLICATIONS OF LAPAROSCOPIC-ASSISTED COLECTOMY

Background: This study was performed to prospectively assess the compl ications of 118 consecutive patients who underwent laparoscopic assist ed colorectal resections. Methods: The variables included were: indica tion for surgery, type of resection, duration of operation, duration o f postoperative ileus, length of hospital stay, port-site recurrence, and complications in relation to the laparoscopic technique. Results: 118 Laparoscopic-assisted procedures were performed between July 1992 and October 1995. Surgical indications were: 106 patients for colonic malignancy, six for diverticulitis, two for Crohn's disease, two for b enign polyps, one for endometriosis, and one for ischemic colitis. Fif teen patients required conversion to open techniques for completion of the operations (12.7%). The mean operating time was 168.8 min. The am ount of operative blood loss was 98 mi. The mean time for passing flat us was 36 +/- 16 h. Mean postoperative stay was 5.4 (range 3-13) days. Eight patients (6.8%) sustained complications: four unrelated to lapa roscopy (three wound infection, one anastomotic leak); and four compli cations related to the laparoscopic approach: one small-bowel obstruct ion, one trocar injury, one rotation of the anastomosis, and one misdi agnosed synchronous adenocarcinoma. Conclusions: We suggest that with the development of improved technical devices and more experience, the indications for laparoscopic colectomy should continue to expand. The low incidence of infectious complications suggests an important role for the laparoscopic approach to colorectal surgery.