Adhesive intestinal obstruction in laparoscopic vs open colorectal resection


N. Naguib, Department of Colorectal Surgery, Prince Charles Hospital, 21 Heol Corn Du, Merthyr Tydfil, CF48 1BW, UK.


Aim  While there is evidence that laparoscopy creates fewer adhesions, evidence regarding decreased episodes of adhesive obstruction in laparoscopic colorectal resection (LCR) is still lacking. The aim of our study was to compare the incidence of adhesion-related admissions/surgery in patients undergoing LCR and open colorectal resection (OCR).

Method  We conducted a retrospective analysis of a prospectively collected database that included all patients undergoing LCR and OCR between 2001 and 2010. Patients with < 6 months of follow-up were excluded. Patients who were converted to open surgery were included in the laparoscopic group. Details regarding readmission rates and surgery for adhesive obstruction were obtained from clinical portals and the theatre database. Statistical analysis was performed using Fisher’s exact test, the Mann–Whitney U-test and the Student’s t-test.

Results  One-hundred and forty-four patients had LCR with a median (range) follow-up of 24.5 (6–108) months. One-hundred and eighty-seven patients underwent OCR, with a median (range) follow-up of 49 (6–104) months. Six (4.2%) of 144 patients in the LCR group had adhesion-related admission/obstruction compared with 13 (6.95%) of 187 patients in the OCR group (P = 0.34). Three (2.1%) of 144 patients who had LCR required surgery for adhesive obstruction compared with five (2.7%) of 187 who had OCR (P = 0.73).

Conclusion  In our study there was no statistically significant difference in the incidence of postoperative adhesive intestinal obstruction between LCR and OCR groups.