Abstract
BackroundOpen or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital.MethodsA literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library.ResultsThis review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications.ConclusionThis review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications.
Highlights
Colorectal surgery is performed for many diseases such as colorectal cancer, ulcerative colitis, Crohn’s disease, mechanical bowel obstruction and recurrent diverticulitis, often resulting in major reconstruction of the gastrointestinal tract
The lack of consensus on how to define and grade postoperative complications has greatly hampered the evaluation of surgical procedures
A new classification of complications, initiated in 1992 by Clavien and Dindo is based on the type of therapy needed to correct the
Summary
Colorectal surgery is performed for many diseases such as colorectal cancer, ulcerative colitis, Crohn’s disease, mechanical bowel obstruction and recurrent diverticulitis, often resulting in major reconstruction of the gastrointestinal tract. Ischemia, rectal prolapse and proctological disorders may require large or small bowel resection. Potential risks of colorectal surgery are mainly those of any major abdominal surgery, and usually occur while the patient is still in the hospital. Because of the many indications for and the various extents of colorectal or small bowel resections the rate and spectrum of complications differ. The lack of consensus on how to define and grade postoperative complications has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992 by Clavien and Dindo is based on the type of therapy needed to correct the
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