Comparison of the results of laparoscopic and open surgery in the reintervention of patients with severe postoperative complications

Abstract

Introduction: Serious postoperative complications lead to reinterventions, which increase the risk of further complications and death. There are 2 methods for performing abdominal reintervention: Open surgery (OS) or laparoscopic surgery (LS). Objective: To compare the results of laparoscopic surgery and open surgery in reinterventions of patients with serious postoperative complications. Method: Quasi-experimental study in 155 patients with severe postoperative complications. Two groups were compared: CL (n= 71) and CA (n= 84) regarding (preoperative): cause of reintervention, mean arterial pressure, heart rate and time to reintervention; and (postoperative): Complications, further reinterventions and death. Results: Before reintervention, mean arterial pressure was similar in both groups (experimental 91.3 mmHg; control 89.5 mmHg); The percentage of cases with previous OS in the experimental group was 67.6 %, and in this group anastomotic leak (42.65 %) and postoperative peritonitis (25 %) predominated. After reintervention, surgical site infection (59.7 % vs. 16.2 %) and external intestinal fistulas (22.6 %) were higher in the control group. There were more deaths in the control group (27.4 % vs. 8.5 %) and 23 patients with new reinterventions were reported in this group, vs. 6 patients in the experimental group. Conclusions: Laparoscopic surgery showed better results than open surgery in the reintervention of patients with serious postoperative complications; there was less use of blood products, fewer reinterventions, complications and death.

Keywords

• complicaciones posoperatorias
• laparoscopia
• reoperación.