Intraoperative Colonoscopy for Anastomosis Assessment in Laparoscopically Assisted Left-Sided Colon Resection: Is It Worthwhile?

摘要

Background: The aim of our study was to evaluate the use of intraoperative colonoscopy in laparoscopicallynassisted left-sided colon resection for the assessment of anastomosis.nMaterials and Methods: All consecutive laparoscopically assisted left-sided colon resections performednat our department between May 2001 and February 2006 were included in this study. Afterncolon resection and reanastomosis, an intraoperative colonoscopy was performed to detect anastomosisnrisk.nResults: A total of 122 patients were enrolled in this study. In 73 patients (59.84%), the anastomosisnwas checked via colonoscopy (the study group, (SG), whereas the control group (CG) consistednof 49 (40.16%) patients without colonoscopy. Of the 122 patients, 65 (53.28%) underwent anlaparoscopically assisted sigmoid resection, 45 (36.89%) a laparoscopically assisted sigmoid rectumnresection, 4 (3.28%) a laparoscopically assisted anterior rectum resection, and 8 (6.56%) a laparoscopicallynassisted left hemicolectomy. In the study group, 5 (6.85%) anastomotic leakages were intraoperativelyndetected and oversewn. A total of 6 (4.92%) anastomotic leakages occurred in thenearly postoperative period (SG: 4 [5.47%] vs. CG: 2 [4.08%]; P u0002 0.541).nConclusions: Intraoperative evaluation of anastomosis prevents early anastomotic insufficiency becausenintraoperative identification of leaks allows for repair during surgery. Nevertheless, a certain ratenof anastomotic dehiscence occurs in every kind of colon resection. The sometimes increased rate of dehiscencenin laparoscopic-assisted colon resection can be reduced by intraoperative colonoscopy.