Skip to main content
Log in

Does Prior Abdominal Surgery Influence Conversion Rates and Outcomes of Laparoscopic Right Colectomy in Patients with Neoplasia?

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

The study investigated the impact of prior abdominal surgery on conversions and outcomes of laparoscopic right colectomy.

Methods

A consecutive series of 414 patients with cancer or adenomas who underwent a laparoscopic right colectomy from March 1996 to November 2006 were studied for surgical conversions and outcomes. Conversion was defined as an incision length > 7 cm.

Results

Patients with prior abdominal surgery (n = 191) were compared with patients with no prior abdominal surgery (n = 223), and showed no significant differences in age, ASA classification, length of stay, operative time, blood loss, harvested nodes, tumor size, and specimen length. Significantly more wound infections occurred in the prior abdominal surgery group (22 vs.12, P = 0.023). Body mass index > 30 showed a three-fold increased risk of conversion.

Fifteen percent of the no prior abdominal surgery patients and 17 percent of the prior abdominal surgery patients were converted (P > 0.05). Conversion was associated with a longer mean length of stay (8.8 days) relative to laparoscopically completed cases (6.3 days) regardless of prior abdominal surgery history (P < 0.0001).

Conclusions

Laparoscopic right colectomy for neoplasia was not associated with a higher conversion rate or morbidity in patients with prior abdominal surgery. Prior abdominal surgery is not a contraindication to laparoscopic right colectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fowler DL, White SA, Anderson CA. Laparoscopic colon resection: 60 cases. Surg Laparosc Endosc 1995;5:468–71.

    PubMed  CAS  Google Scholar 

  2. Nelson H, Sargent DJ, Wieand HS, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350:2050–9.

    Article  CAS  Google Scholar 

  3. Zheng MH, Feng B, Lu AG, et al. Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol 2005;11:323–6.

    PubMed  Google Scholar 

  4. Lacy A, García-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359:2224–9.

    Article  PubMed  Google Scholar 

  5. Ellis H. The causes and prevention of intestinal adhesions. Br J Surgery 1982;69:241–3.

    Article  CAS  Google Scholar 

  6. Weibel MA, Manjo G. Peritoneal adhesions and their relation to abdominal surgery. Am J Surg 1973;126:345–53.

    Article  PubMed  CAS  Google Scholar 

  7. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology and clinical significance. Recent advances in prevention and management. Dig Surg 2001;18:260–73.

    Article  PubMed  CAS  Google Scholar 

  8. Suslavich FJ, Turner NA, King PS, Brown HK. Intraabdominal adhesions: intraoperative US. Radiology 1989;172:387–9.

    PubMed  CAS  Google Scholar 

  9. Curet MJ. Special problems in laparoscopic surgery. Previous abdominal surgery, obesity and pregnancy. Surg Clin North Am 2000;80:1093–100.

    Article  PubMed  CAS  Google Scholar 

  10. Miller K, Holbling N, Hutter J, Junger W, Moritz E, Speil T. Laparoscopic cholecystectomy for patients who have had previous abdominal surgery. Surg Endosc 1993;7:400–3.

    Article  PubMed  CAS  Google Scholar 

  11. Wongworawat MD, Aitken DR, Robles AE, Garberoglio C. The impact of prior intra-abdominal surgery on laparoscopic cholecystectomy. Am Surg 1994;60:763–6.

    PubMed  CAS  Google Scholar 

  12. Parsons JK, Jarrett TJ, Chow GK, Kavoussi LR. The effect of previous abdominal surgery on urological laparoscopy. J Urol 2002;168:2387–90.

    Article  PubMed  Google Scholar 

  13. Law WL, Lee YM, Chu W. Previous abdominal operations do not affect the outcomes of laparoscopic colorectal surgery. Surg Endosc 2005;19:326–30.

    Article  PubMed  CAS  Google Scholar 

  14. Hamel CT, Pikarsky AJ, Weiss E, Nogueras J, Wexner SD. Do prior abdominal operations alter the outcome of laparoscopically assisted right hemicolectomy? Surg Endosc 2000;14:853–7.

    Article  PubMed  CAS  Google Scholar 

  15. Arteaga IG, Malagón MA, López-Tomassetti Fernández EM, Arranz DJ, Díaz LH, Carrillo PA. Impact of previous abdominal surgery on colorectal laparoscopy results: a comparative clinical study. Surg Laparosc Endosc Percutan Tech 2006;16:8–11.

    Article  Google Scholar 

  16. Ellis H. The clinical significance of adhesions: focus on intestinal obstruction. Eur J Surg 1997;577(Suppl):5–9.

    Google Scholar 

  17. Menzies D, Ellis H. Intestinal obstruction from adhesions: how big is the problem? Ann R Coll Surg Engl 1990;72:60–3.

    PubMed  CAS  Google Scholar 

  18. Diamond MP, Freeman ML. Clinical implications of post surgical adhesions. Hum Reprod Update 2001;7:567–76.

    Article  PubMed  CAS  Google Scholar 

  19. Parker MC, Wilson MS, Menzies D, et al. Colorectal surgery: the risk and burden of adhesion-related complications. Colorectal Dis 2004;6:506–11.

    Article  PubMed  CAS  Google Scholar 

  20. Coleman MG, McLain AD, Moran BJ. Impact of previous surgery on time taken for incision and division of adhesions during laparotomy. Dis Colon Rectum 2000;43:1297–9.

    Article  PubMed  CAS  Google Scholar 

  21. Beck DE, Ferguson MA, Opelka FG, Fleshman JW, Gervaz P, Wexner SD. Effect of previous surgery on abdominal opening time. Dis Colon Rectum 2000;43:1749–53.

    Article  PubMed  CAS  Google Scholar 

  22. Schwander O, Schiedeck TH, Bruch HP. The role of conversion in laparoscopic colorectal surgery: do predictive factors exist? Surg Endosc 1999;13:151–6.

    Article  Google Scholar 

  23. Tekkis PP, Senagore AJ, Delaney CP. Conversion rates in laparoscopic colorectal surgery-a predictive model with 1253 patients. Surg Endosc 2005;19:47–54.

    Article  PubMed  CAS  Google Scholar 

  24. Pikarsky AJ, Saida Y, Yamaguchi T, et al. Is obesity a high-risk factor for laparoscopic colorectal surgery? Surg Endosc 2002;16:855–8.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel L. Feingold M.D..

About this article

Cite this article

Offodile, A.C., Lee, S.W., Yoo, J. et al. Does Prior Abdominal Surgery Influence Conversion Rates and Outcomes of Laparoscopic Right Colectomy in Patients with Neoplasia?. Dis Colon Rectum 51, 1669–1674 (2008). https://doi.org/10.1007/s10350-008-9278-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-008-9278-4

Key Words

Navigation