Laparoscopic versus open end colostomy closure: a single-center experience

Studer, Peter; Schnüriger, Beat; Umer, Melika; Kröll, Dino; Inderbitzin, Daniel; Candinas, Daniel (2014). Laparoscopic versus open end colostomy closure: a single-center experience. American surgeon, 80(4), pp. 361-365. Southeastern Surgical Congress

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The aim of this study was to review our experience with laparoscopic end colostomy closure. A retrospective review of a prospectively entered database was performed. Proportions and continuous variables were compared using the Fisher's exact and the Mann-Whitney U tests, respectively. Within the study period, 53 patients underwent closure of end colostomies. The main reasons for the colonic resections were perforated diverticulitis (52.7%) and neoplasms (20.8%). In 28 patients (53%), laparoscopic closure (LC) was attempted. Demographics did not differ between the attempted LC and the primary open closure (OC) group. The conversion rate from an LC to an OC was 50 per cent (14 of 28), mostly as a result of adhesions (71.4%). Hospital length of stay (HLOS) was significantly longer for the OC than with the attempted LC group (15.4 ± 11.9 days vs 11.3 ± 8.5 days, P = 0.046). The overall complication rate was not different between the completed LC and the OC groups (43 vs 56%, P = 0.634). The majority of complications detected (91.1%) were minor and could be treated conservatively. The role of laparoscopy to close end colostomies is questionable, because the conversion rate is high. However, a shorter HLOS can be expected when laparoscopy is successful. To reduce morbidity resulting from prolonged operation times, it is crucial to convert early and pre-emptively if hostile adhesions are found.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Studer, Peter; Schnüriger, Beat; Umer, Melika; Kröll, Dino; Inderbitzin, Daniel and Candinas, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0003-1348

Publisher:

Southeastern Surgical Congress

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

20 Mar 2015 13:11

Last Modified:

30 Mar 2015 09:12

PubMed ID:

24887666

BORIS DOI:

10.7892/boris.65336

URI:

https://boris.unibe.ch/id/eprint/65336

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