Our Summary

This study looked at the factors that could predict how well patients do after having a laparoscopic colectomy (a minimally invasive surgical procedure to remove part of the colon) following traumatic injury. They used information from a national trauma database and looked at 581 patients who had this procedure within 48 hours of being admitted to the hospital between 2007 and 2015. They found that patients were more likely to die if they had fallen, had a fast heart rate or low blood pressure when they were admitted, or had injuries in multiple parts of their body, particularly the head and chest. Patients were more likely to need additional unplanned surgery if they had resections (removal of parts of the colon) in certain areas, were obese, or had a chronic respiratory disease. The creation of an ostomy (a surgical opening in the body for waste removal) did not affect the chances of death or needing additional surgery. The researchers suggested that more studies are needed to see if adjusting treatment based on these factors can improve patient outcomes.

FAQs

  1. What factors were found to increase the likelihood of death after a laparoscopic colectomy?
  2. Which factors were identified as increasing the need for additional unplanned surgery after a laparoscopic colectomy?
  3. Did the creation of an ostomy affect the chances of death or needing additional surgery after a laparoscopic colectomy?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about laparoscopic colectomy is to follow their post-operative care instructions closely. This may include taking prescribed medications, following a specific diet, and avoiding certain activities to ensure proper healing and recovery. It is also important to attend all follow-up appointments with your healthcare provider to monitor your progress and address any concerns. By following these instructions, patients can optimize their recovery and overall outcome following the procedure.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with conditions such as:

  1. Colorectal cancer
  2. Diverticulitis
  3. Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  4. Colon polyps
  5. Intestinal blockages
  6. Chronic constipation
  7. Colonic volvulus
  8. Colonic ischemia

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if laparoscopic colectomy is the best treatment option for their specific condition.

Timeline

  • Before laparoscopic colectomy:
  1. Patient is admitted to the hospital following traumatic injury.
  2. Patient undergoes diagnostic tests and evaluations to determine the need for surgery.
  3. Patient may have symptoms such as abdominal pain, bloating, constipation, or rectal bleeding.
  4. Surgery is scheduled within 48 hours of admission for laparoscopic colectomy.
  • After laparoscopic colectomy:
  1. Patient undergoes minimally invasive surgery to remove part of the colon.
  2. Recovery period in the hospital typically ranges from 2-5 days.
  3. Patient may experience pain, discomfort, and bloating post-surgery.
  4. Patient is monitored for complications such as infection, bleeding, or bowel obstruction.
  5. Patient may need additional unplanned surgery if complications arise.
  6. Patient may require a temporary ostomy for waste removal.
  7. Patient undergoes follow-up appointments to monitor healing and recovery.
  8. Patient may need dietary and lifestyle changes to adjust to life after colectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic colectomy?
  2. How long is the recovery period after a laparoscopic colectomy?
  3. Will I need to make any lifestyle changes or follow a special diet after the procedure?
  4. How experienced are you in performing laparoscopic colectomies?
  5. What is the success rate of this procedure for patients with my specific condition?
  6. How will my pain be managed after the surgery?
  7. Will I need to have any follow-up appointments or tests after the procedure?
  8. Are there any alternative treatment options to consider?
  9. What factors could affect my outcome after the surgery, based on my medical history?
  10. Can you explain the potential need for additional surgery or complications that may arise during or after the procedure?

Reference

Authors: Cheng V, Schellenberg M, Ashbrook M, Grigorian A, Donohue S, Emigh B, Matsushima K, Inaba K. Journal: Am Surg. 2022 Oct;88(10):2486-2492. doi: 10.1177/00031348221101513. Epub 2022 May 13. PMID: 35549734