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Septic complications of elective laparoscopic colorectal resection
E C Poulin1, C M Schlachta, P A Seshadri
1Department of Surgery, University of Toronto Center for Minimally Invasive Surgery, St. Michael's Hospital, Wellesley Central Site, 160 Wellesley Street East, Toronto, ON, Canada M4Y 1J3.
Background:
We set out to determine the rate and pattern of septic complications of the surgical wound, abdominal cavity, and urinary and respiratory tracts following laparoscopic colorectal resection.
Methods:
A longitudinal database of 500 consecutive cases of colorectal resections was reviewed.
Results:
The total wound infection rate was 7.2% (36/500) and included infections of the abdominal wall wounds (32/500, 6.4%) and the perineal wounds (4/50, 8%). The anastomotic leak rate in 418 patients who underwent resection with primary anastomosis was 3.3% (14/418). Intraabdominal abscesses were diagnosed in 1% (5/500) of patients. Urinary tract infections were rare (3/500, 0.6%), as was postoperative pneumonia (6/500, 1%).
Conclusions:
This study confirms the low rate of postoperative pneumonia observed with all other minimally invasive procedures. Intraabdominal abscesses, urinary tract infections, and postoperative pneumonia occur considerably less frequently than in reported historical controls for open surgery. The rates of abdominal wound infection and anastomotic leak in laparoscopic colorectal resection appear to be equivalent to traditional surgery, whereas the rate of perineal wound sepsis is lower. Comparative studies are needed to determine the differential costs of the septic episodes associated with the two approaches.