Wound complications of laparoscopic vs open colectomy

E. R. Winslow, J. W. Fleshman, E. H. Birnbaum, L. M. Brunt

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195 Scopus citations

Abstract

Background: This study was conducted to determine if laparoscopic colon surgery has changed the incidence of wound complications after colon resection. Methods: Eighty-three patients were randomized to undergo either laparoscopic (LCR) or open colon resection (OCR) for cancer at our institution as part of a multicenter trial. Data were tabulated from review of the prospective database and physician records. Results: Thirty-seven patients were randomized to LCR and 46 to OCR. Seven patients in the LCR group were converted to OCR. LCR was performed using a limited midline incision for anastomosis and specimen extraction. Incision length was significantly greater (p < 0.001) in the OCR group (19.4 ± 5.6 cm) compared to the LCR extraction site (6.3 ± 1.4 cm). Wound infections occurred in 13.5% of patients after LCR (2.7% trocar, 10.8% extraction sites) and in 10.9% of patients after OCR. Over a mean follow-up period of 30.1 ± 17.8 months, incisional hernias developed in 24.3% of patients after LCR and 17.4% after OCR. In the LCR group, extraction sites accounted for 85.7% of all wound complications. Conclusions: The extraction site for LCR is associated with a high incidence of complications, comparable to open colectomy. Strategies to alter operative technique should be considered to reduce the incidence of these complications.

Original languageEnglish
Pages (from-to)1420-1425
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume16
Issue number10
DOIs
StatePublished - Oct 1 2002

Keywords

  • Colon cancer
  • Incisional hernia
  • Laparoscopic colectomy
  • Wound infection

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