Purpose: Adhesions due to pervious abdominal surgery cause the difficulty on reoperation. The aim of this study was to share our experience of laparoscopic colorectal resection in patients with previous abdominal surgery.
Methods: Between January 2001 and October 2002, 22 patient with previous abdominal surgery underwent laparoscopic resection for colorectal cancer. The type of previous abdominal surgery, type of laparoscopic surgery, operative time, blood loss, complication and conversion rate were analyzed.
Results: Previous abdominal surgery included 7 appendectomies, 2 open cholecystectomies, 2 appendectomies and open cholecystectomies, 2 Cesarean sections, 1 hysterectomy and salpingoophorecomy, 1 salpingoophorectomy, 1 tubal ligation, 1 total gastrectomy, 1 subtotal gastrectomy, 1 antrectomy, 1 low anterior resection, 1 ileocolectomy and transabdominal prostatectomy. The types of laparoscopic procedure were 10 low anterior resections, 6 anterior resections, 3 Right colectomies, 1 Left colectomy, 1 abdomino-perineal resection, and 1 ultralow anterior resection. Mean operative time and mean blood loss were 198.2 minutes and 100 ml, respectively. Mean hospital stay was 10.9 days. Conversion to an open procedure was not required. There were two intraoperative complications: 1 ureter injury not related to the adhesion and 1 small bowel perforation related to the adhesions. Three postoperative complications were occurred: 2 wound seroma and 1 urinary retention.
Conclusion: Laparoscopic colorectal resection can be offered to patients with previous abdominal surgery. Small bowel injury beyond the laparoscopic visualization should be considered during laparoscopic colorectal resection in these patients.
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