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Clin Colon Rectal Surg 2003; 16(2): 143-152
DOI: 10.1055/s-2003-40593
DOI: 10.1055/s-2003-40593
Perioperative Complications in Colorectal Surgery
Further Information
Publication History
Publication Date:
18 July 2003 (online)
ABSTRACT
Colorectal procedures are at risk for both major and minor complications, the majority of which are potentially preventable by an experienced surgeon. Preventable technical complications include inadvertent injury to adjacent viscera (vascular supply, urinary tract, spleen, small bowel, peripheral nerves, sphincter muscles, or presacral vessels) and reconstructive problems (stapler-related complications, anastomotic leak, and wound closure). The former can be avoided by meticulous dissection and by respecting tissue planes, even in the face of prior laparotomy. The latter requires a well-vascularized, tension-free anastomosis. Early recognition and management of postoperative ileus, urinary retention, wound, and intra-abdominal infection are important means of reducing morbidity and mortality for the colorectal surgical patient.
KEYWORDS
Colorectal surgery - complication - inadvertent injury - anastomotic leak - stapler-related problems - postoperative ileus - urinary retention - laparoscopy
REFERENCES
- 1 Corman M L. Carcinoma of the rectum. In: Corman ML (ed) Colon and Rectal Surgery, 4th ed. Philadelphia, PA: Lippincott-Raven 1998 : 733-862
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- 2 Nelson H, Petrelli N, Carlin A. et al . Guidelines 2000 for colon and rectal cancer surgery. J Nat Can Inst . 2001; 93 583-596
- 3 Kern K A. Medical malpractice involving colon and rectal disease: a 20-year review of United States Civil Court litigation. Dis Colon Rectum . 1993; 36 531-539
- 4 Leff E I, Groff W, Rubin R J, Eisenstat T E, Salvati E P. Use of ureteral catheters in colonic and rectal surgery. Dis Colon Rectum . 1982; 25 457-460
- 5 Kyzer S, Gordon P H. The prophylactic use of ureteral catheters during colorectal operations. Am Surg . 1994; 60 212-216
- 6 Watterson J D, Mahoney J E, Futter N G, Gaffield J. Iatrogenic ureteric injuries: approaches to etiology and management. Can J Surg . 1998; 41 379-382
- 7 Witters S, Cornelissen M, Vereecken R. Iatrogenic ureteral injury: aggressive or conservative treatment. Am J Obstet Gynecol . 1986; 155 582-584
- 8 Schoetz Jr J D. Complications of surgical excision of rectum. Surg Clin North Am . 1991; 71 1271-1281
- 9 Pearse H D, Barry J M, Fuchs E F. Intraoperative consultation for the ureter. Urol Clin North Am . 1985; 12 423-437
- 10 Fry D E, Milholen L, Harbrecht P J. Iatrogenic ureteral injury: options in management. Arch Surg . 1983; 118 454-457
- 11 Sheikh F A, Khubchandani I T. Prophylactic ureteric catheters in colon surgery: how safe are they?. <~>Report of three cases. Dis Colon Rectum . 1990; 33 508-510
- 12 Ostrzenski A, Ostrzenka K M. Bladder injury during laparoscopic surgery (review). Obstet Gynecol Surv . 1998; 53 175-180
- 13 Lapides J L, Tank E S. Urinary complications following abdominal perineal resection. Cancer . 1971; 28 230-235
- 14 Ward J N, Nay H R. Immediate and delayed urologic complications associated with abdominoperineal resection. Am J Surg . 1972; 123 642-648
- 15 Wagner J R, Russo P. Urologic complications of major pelvic surgery. Semin Surg Oncol . 2000; 18 216-228
- 16 Montesani C, Ribotta G, De Milito R. et al . Extended resection in the treatment of colorectal cancer. Int J Colorectal Dis . 1991; 6 161-164
- 17 Slanetz Jr A C. The effect of inadvertent intraoperative perforation on survival and recurrence in colorectal surgery. Dis Colon Rectum . 1984; 27 792-797
- 18 Keynes W M. Implantation from bowel lumen in cancer of large intestine. Ann Surg . 1961; 153 357-364
- 19 Herrera-Ornelas L, Tolls R M, Petrell N J, Piver S, Mittelman A. Common peroneal nerve palsy associated with pelvic surgery for cancer: an analysis of 11 cases. Dis Colon Rectum . 1986; 29 392-397
- 20 Kubiak R, Wilcox D T, Spitz L, Kiely E M. Neurovascular morbidity from the lithotomy position. J Pediatr Surg . 1998; 33 1808-1810
- 21 Mubarek S J, Hargens A R. Acute compartment syndromes. Surg Clin North Am . 1981; 63 539-565
- 22 Sinclair R H, Pratt J H. Femoral neuropathy after pelvic operation. Am J Obstet Gynecol . 1972; 112 404-407
- 23 Langevin J M, Rothenberger D A, Goldberg S M. Accidental splenic injury during surgical treatment of colon and rectum. Surg Gynecol Obstet . 1984; 159 139-144
- 24 Nyam D C, Seow-Choen F, Ho Y H. Submucosal adrenaline injection for posthemorrhoidectomy hemorrhage. Dis Colon Rectum . 1995; 38 776-777
- 25 Qinyao W, Weijin S, Youren Z, Wenqing Z, Zhengrui H. New concepts in severe presacral hemorrhage during proctectomy. Arch Surg . 1985; 120 1013-1020
- 26 Barras J P, Fellmann T H. Massive Blutung aus den präsakralen Venen während der Resektion des Rectums (in German with English abstract). Helv Chir Acta . 1992; 59 335-339
- 27 Remzi F H, Oncel, Fazio V W. Muscle tamponade to control presacral venous bleeding. Dis Colon Rectum . 2002; 45 1109-1111
- 28 Zama N, Fazio V W, Jagelman D G, Lavery I C, Weakley F L, Church J M. Efficacy of pelvic packing in maintaining hemostasis after rectal excision for cancer. Dis Colon Rectum . 1988; 31 923-928
- 29 Vignali A, Fazio V W, Lavery I C. et al . Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients. . 1997; 185 105-113
- 30 Averback A M, Chang D, Koslowe P, Sugarbaker P H. Anastomotic leak after double-stapled low colorectal resection: an analysis of risk factors. Dis Colon Rectum . 1996; 39 780-787
- 31 Manson P N, Corman M L, Coller J A, Veidenheimer M C. Anterior resection for adenocarcinoma: Lahey Clinic experience from 1963 through 1969. Am J Surg . 1976; 131 434-441
- 32 Golub R, Golub R W, Cantu Jr R, Stein D H. A multivariate analysis of factors contributing to leakage of intestinal anastomoses. J Am Coll Surg . 1997; 184 364-372
- 33 Parc Y, Frileux P, Schmitt G, Dehni N, Ollivier J M, Parc R. Management of postoperative peritonitis after anterior resection: experience from a referral intensive care unit. Dis Colon Rectum . 2000; 43 579-589
- 34 Hirsch C J, Gingold B S, Wallack M K. Avoidance of anastomotic complications in low anterior resection of the rectum. Dis Colon Rectum . 1997; 40 42-46
- 35 Smith S RG, Swift I, Gompertz H, Baker W NW. Abdominoperineal and anterior resection of the rectum with retrocolic omentoplasty and no drainage. Br J Surg . 1988; 75 1012-1015
- 36 Urbach D R, Kennedy E D, Cohen M M. Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. Ann Surg . 1999; 229 174-180
- 37 Lazorthes F, Chiotassol P. Stapled colorectal anastomoses: preoperative integrity of the anastomosis and risk of postoperative leakage. Int J Colorect Dis . 1986; 1 96-98
- 38 Griffith C DM, Hardcastle J D. Intraoperative testing of anastomotic integrity after stapled anterior resection for cancer. J R Coll Surg Edinb . 1990; 35 106-108
- 39 Beard J D, Nicholson M L, Sayers R D, Lloyd D, Everson N W. Intraoperative air testing of colorectal anastomoses: a prospective, randomized trial. Br J Surg . 1990; 77 1095-1097
- 40 Cherqui D, Valleur P, Perniceni T, Hautefeuille P. Inferior reach of ileal reservoir in ileoanal anastomosis: experimental anatomic and angiographic study. Dis Colon Rectum . 1987; 30 365-371
- 41 Smith L, Friend W G, Medwell S J. The superior mesenteric artery: the critical factor in the pouch pull-through procedure. Dis Colon Rectum . 1984; 27 741-744
- 42 Martel P H, Majery N, Savingny B, Sezeur A, Gallot D, Malafose M. Mesentery lengthening in ileoanal pouch anastomosis for ulcerative colitis: is high division of the superior mesenteric pedicle a safe procedure?. Dis Colon Rectum . 1998; 41 862-867
- 43 Oncel M, Remzi F H, Senagore A J, Connor J T, Fazio V W. Comparison of a novel liquid (Adcon-P) and a sodium hyaluronate and carboxymethylcellulose membrane (Seprafilm) in postsurgical adhesion formation in a murine model. Dis Colon Rectum . 2003; 46 187-191
- 44 Becker J M, Dayton M T, Fazio V W, Beck D E. et al . Prevention of postoperative abdominal adhesions by a sodium hyaluronate-based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Col Surg . 1996; 183 297-306
- 45 Ogilvy A J, Smith G. The gastrointestinal tract after anesthesia. Eur J Anaesthesiol . 1995; 12 (suppl 10) 35-42
- 46 Delaney C P, Fazio V W, Senagore A J, Robinson B, Halverson A, Remzi F H. Fast-track post-operative management protocol for patients with high comorbidity undergoing complex abdominal and pelvic colorectal surgery. Br J Surg . 2001; 88 1533-1538
- 47 Verlinden M, Michiels G, Bogfaert A. et al . Treatment of postoperative gastrointestinal atony. Br J Surg . 1987; 74 277-286
- 48 Zaheer S, Reilly W T, Pemberton J H, Ilstrup D. Urinary retention after operations for benign anorectal disease. Dis Colon Rectum . 1998; 41 696-704
- 49 Petros J G, Bradley T M. Factors influencing postoperative urinary retention in patients undergoing surgery for benign anorectal disease. Am J Surg . 1990; 159 374-376
- 50 Prasad M L, Abcarian H. Urinary retention following operations for benign anorectal diseases. Dis Colon Rectum . 1978; 21 490-492
- 51 Bailey H, Ferguson J A. Prevention of urinary retention by fluid restriction following anorectal operations. Dis Colon Rectum . 1976; 19 250-252
- 52 Goldman G, Kahn P J, Kashtan H, Stadler J, Wiznitzer T. Prevention and treatment of urinary retention and infection after surgical treatment of the colon and rectum with alpha adrenergic blockers. Surg Gynecol Obstet . 1988; 166 447-450
- 53 Cataldo P A, Senagore A J. Does alpha sympathetic blockade prevent urinary retention following anorectal surgery?. Dis Colon Rectum . 1991; 34 1113-1116
- 54 Benoist S, Panis Y, Denet C, Mauvais F, Mariani P, Valleur P. Optimal duration of urinary drainage after rectal resection: a randomized controlled trial. Surgery . 1999; 125 135-141
- 55 Hojo K, Vernava A M, Sugihara K, Katumata K. Preservation of urine voiding and sexual function after rectal cancer surgery. Dis Colon Rectum . 1991; 34 532-539
- 56 Rappaport W D, Putnam C. Sidewinder retention sutures for closure of the abdominal wall. Surg Gynecol Obstet . 1989; 169 73-74
- 57 Halevy A, Oland Y, Adam Y G. Stainless steel wire for closure of abdominal operative wounds. Am J Surg . 1978; 44 342-345
- 58 Saxe J M, Ledgerwood M, Lucas C E. Management of the difficult abdominal closure. Surg Clin North Am . 1993; 73 243-51
- 59 Baptista M L, Bonsack M E, Delaney J P. Seprafilm reduces adhesions to polypropylene mesh. Surgery . 2000; 128 86-92
- 60 Porter J M. A combination of Vicryl and Marlex mesh: a technique for abdominal wall closure in difficult cases. J Trauma . 1995; 39 1178-1180
- 61 Stone H H, Strom P R, Mullins R J. Pancreatic abscess management by subtotal resection and packing. World J Surg . 1984; 8 340-345
- 62 Seshadri P A, Poulin E C, Schlachta C M, Cadeddu M O, Mamazza J. Does a laparoscopic approach to total abdominal colectomy and proctocolectomy offer advantages?. Surg Endosc . 2001; 15 837-842
- 63 Senagore A J, Duepree H J, Delaney C P. et al . Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: similarities and differences. Dis Colon Rectum . 2002; 45 485-490
- 64 Duepree H J, Senagore A J, Delaney C P, Brady K M, Fazio V W. Advantages of laparoscopic resection for ileocecal Crohn's disease. Dis Colon Rectum . 2002; 45 605-610