Laparoscopic redo ileocolic anastomosis for anastomotic leakage after right hemicolectomy: A case report

Table 1 Timeline of clinical events

Time point	Event	Details
Hospital day 1	Emergency department visit	77-year-old man presented with hematochezia; multiple comorbidities (HTN, DM, AF, CKD on hemodialysis, prior NSTEMI)
Hospital day 1-2	Initial conservative management	Temporary discontinuation of clopidogrel; persistent hematochezia despite 2 days of conservative treatment
Hospital day 3	Diagnostic colonoscopy	Ascending colon cancer with active luminal bleeding
Hospital day 5	Initial surgery	Laparoscopic right hemicolectomy with D3 complete mesocolic excision and central vascular ligation; extracorporeal side-to-side ileocolic anastomosis; omental coverage
Postoperative day 1-5	Early postoperative course	Initially stable; minimal drain output (2-3 mL/day)
Postoperative day 6	Clinical deterioration	Recurrent hematochezia (> 800 g within 6 hours); colonoscopy showed blood clot at anastomosis without active bleeding
Postoperative day 6	Diagnostic confirmation	Sudden increase in drain output (approximately 50 mL/30 minutes); CT showed perianastomotic inflammation and free air to anastomotic leakage diagnosed
Postoperative day 6	Emergency reoperation	Laparoscopic redo ileocolic anastomosis performed; careful retroperitoneal assessment; extracorporeal reconstruction; selective protective loop ileostomy
Postoperative day 1-2 after reoperation	Post-reoperation recovery	Intensive care unit care for 2 days due to cardiac history; oral intake resumed on postoperative day 2 after redo surgery
Postoperative day 8 after reoperation	Discharge	Uneventful recovery; discharged without further complications

HTN: Hypertension; DM: Diabetes mellitus; AF: Atrial fibrillation; CKD: Chronic kidney disease; NSTEMI: Non-ST elevation myocardial infarction; CT: Computed tomography.