Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Re-operative laparoscopic colorectal surgery is increasingly prevalent.
• While challenging, it presents potential benefits over open surgery.
• This review examines its safety and efficacy.

Purpose of the Study:

• To systematically review the literature on re-operative laparoscopic colorectal surgery.
• To compare outcomes between laparoscopic and open re-operations.
• To assess the safety and effectiveness of laparoscopic approaches in complex colorectal procedures.

Main Methods:

• Systematic review of retrospective and prospective cohort studies and case series.
• Exclusion of case reports.
• Data synthesis from 17 articles published between 2007 and 2020.

Main Results:

• 1555 patients analyzed; 574 underwent laparoscopic procedures, 981 open re-operations.
• Laparoscopic surgery showed significantly lower mortality (2.78% vs. 9.4%) and morbidity (102 vs. 137 cases).
• Median length of stay was shorter for laparoscopic procedures (5.8-19 days) compared to open (9.7-34 days).
• Conversions to open surgery occurred in 39 instances.

Conclusions:

• Re-operative laparoscopic colorectal surgery is a safe and effective option when performed by experienced surgeons.
• It is suitable for managing complications, malignancy recurrence, and pelvic dissections.
• The procedure is associated with a low complication rate and infrequent conversions to open surgery.