2013 Volume 33 Issue 1 Pages 73-79
As we think laparoscopic surgery contributes to the recovery after abdominal emergency operations, we apply laparoscopic coloproctectomy in abdominal emergency cases. We experienced 89 cases of laparoscopic coloproctectomy for acute abdomen (69 large bowel obstruction cases, 17 peritonitis cases, 2 cases with large intestinal bleeding and 1 ischemic colitis case) in the past 11 and a half years. On the basis of the indication of elective laparoscopic coloproctectomy, we apply emergency laparoscopic colo-proctectomy for cases of decompressed large bowel obstruction with intraperitoneal working space, localized and/or iatrogenic panperitonitis with empty intestine after mechanical bowel preparation and large intestinal bleeding or ischemic colitis for those patients in a hemodynamically and generally stable condition. Principally for the emergency cases, we operate in the same way as the elective cases, but we should well recognize the special attention required associated with emergency laparoscopic coloproctectomies. The rate of conversion to open surgery was 2.2% and the rate of pure-laparoscopic surgery was 59.6%. The result of all cases of 10 benign bowel obstruction, peritonitis, large intestinal bleeding and ischemic colitis were acceptable. Both the results of the operation and the cancer prognosis were acceptable in the 59 cases of cancer associated with large bowel obstruction at the same time. The laparoscopic coloproctectomy is useful for the acute abdomen within strict indication limits.
