Surgical Endoscopy

, Volume 25, Issue 12, pp 3755–3760 | Cite as

Bowel obstruction after laparoscopic and open colon resection for cancer: Results of 5 years of follow-up in a randomized trial

  • Johnna Schölin
  • Mark Buunen
  • Wim Hop
  • Jaap Bonjer
  • Bo Anderberg
  • Miguel Cuesta
  • Salvadora Delgado
  • Ainitze Ibarzabal
  • Marie-Louise Ivarsson
  • Martin Janson
  • Antonio Lacy
  • Johan Lange
  • Lars Påhlman
  • Stefan Skullman
  • Eva Haglind
Article

Abstract

Background

Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared.

Methods

A retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery.

Results

Baseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant.

Conclusions

This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.

Keywords

Colorectal cancer Surgical technique Complications Adhesions Bowel obstruction Laparoscopy 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Johnna Schölin
    • 1
  • Mark Buunen
    • 2
  • Wim Hop
    • 3
  • Jaap Bonjer
    • 4
  • Bo Anderberg
    • 5
  • Miguel Cuesta
    • 4
  • Salvadora Delgado
    • 6
  • Ainitze Ibarzabal
    • 6
  • Marie-Louise Ivarsson
    • 7
  • Martin Janson
    • 8
  • Antonio Lacy
    • 6
  • Johan Lange
    • 2
  • Lars Påhlman
    • 9
  • Stefan Skullman
    • 10
  • Eva Haglind
    • 1
  1. 1.Department of SurgeryOmråde 2, Sahlgrenska University Hospital/ÖstraGöteborgSweden
  2. 2.Department of SurgeryErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Department of BiostatisticsErasmus Medical CenterRotterdamThe Netherlands
  4. 4.Department of SurgeryVrije Universiteit Medical Centre (VUmc)AmsterdamThe Netherlands
  5. 5.Department of SurgeryCapio St: Göran’s HospitalStockholmSweden
  6. 6.Department of SurgeryHospital ClinicBarcelonaSpain
  7. 7.Department of SurgeryKungsbacka HospitalKungsbackaSweden
  8. 8.Department of SurgeryKarolinska University HospitalHuddingeSweden
  9. 9.Department of SurgeryAkademiska HospitalUppsalaSweden
  10. 10.Department of SurgerySkövde HospitalSkövdeSweden

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