Emergency laparoscopic colectomy: does it measure up to open?

Stulberg, Jonah J.; Champagne, Brad J.; Fan, Zhen; Horan, Mike; Obias, Vincent; Marderstein, Eric; Reynolds, Harry; Delaney, Conor P.

doi:10.1016/j.amjsurg.2008.09.010

« Previous Next »The American Journal of Surgery
Volume 197, Issue 3 , Pages 296-301, March 2009

Emergency laparoscopic colectomy: does it measure up to open?

Jonah J. Stulberg, M.P.H.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
- Corresponding author. Tel.: +1-216-844-8649; fax: +1-216-844-5957
Brad J. Champagne, M.D.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
Zhen Fan, M.D.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
Mike Horan, D.D.S., Ph.D.
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
Vincent Obias, M.D.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
Eric Marderstein, M.D., M.P.H.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
Harry Reynolds, M.D.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA
Conor P. Delaney, M.D., Ph.D., M.Ch.
- Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., LKS 7, MS 5047, Cleveland, OH 44106-5047, USA

Received 19 August 2008; received in revised form 18 September 2008

Abstract

Background

Laparoscopic colectomy has become the standard of care for elective resections; however, there are few data regarding laparoscopy in the emergency setting.

Methods

By using a database with prospectively collected data, we identified 94 patients who underwent an emergency colectomy between August 2005 and July 2008. Laparoscopic surgeries were performed in 42 patients and were compared with 25 patients who were suitable for laparoscopy but received open colectomy.

Results

The groups had similar demographics with no differences in age, sex, or surgical indications. Blood loss was lower (118 vs 205 mL; P < 0.01) and the postoperative stay was shorter (8 vs 11 d; P = 0.02) in the laparoscopic patients, and perioperative mortality rates were similar between the 2 groups (1 vs 3; P = 0.29).

Conclusions

With increasing experience, laparoscopic colectomy is a feasible option in certain emergency situations and is associated with shorter hospital stay, less morbidity, and similar mortality to that of open surgery.

Keywords: Laparoscopic emergency colectomy, Emergent colectomy, Urgent colectomy, Laparoscopy, Colectomy