Adhesive small bowel obstruction after laparoscopic and open colorectal surgery: a systematic review and meta-analysis - 24/08/16
, Jong Hun Kim, M.D., Ph.D.Abstract |
Background |
It is considered that laparoscopic surgery is associated with a much lower rate of postoperative formation of adhesions than open surgery. This meta-analysis assessed the incidence of adhesion-related readmissions and surgery for adhesive small bowel obstruction (SBO) in patients who underwent laparoscopic or open colorectal surgery.
Methods |
Multiple comprehensive databases were searched systematically to identify relevant studies and meta-analysis was done.
Results |
Meta-analysis showed that laparoscopic surgery was associated with a lower rate of adhesive SBO, both for randomized clinical trials (relative risk [RR] .26, 95% confidence interval [CI] .10 to .67, I2=41%) and nonrandomized studies (RR .49, 95% CI .32 to .76, I2=91%). Laparoscopic surgery was also associated with a lower rate of subsequent surgery for adhesive SBO, both for randomized clinical trials (RR .25, 95% CI .06 to .96, I2=0%) and nonrandomized studies (RR .56, 95% CI .33 to .94, I2=77%).
Conclusions |
Laparoscopic colorectal surgery significantly reduced the rates of adhesive SBO and subsequent surgery for adhesive SBO, compared with open surgery.
Le texte complet de cet article est disponible en PDF.Highlights |
• | It remains unclear whether laparoscopy has benefit for reducing incidence of adhesive SBO. |
• | This review identifies reduced incidence of adhesive SBO in laparoscopic colorectal surgery. |
• | Despite these findings, RCTs are needed to confirm the benefit of laparoscopy. |
Keywords : Colorectal surgery, Laparoscopy, Adhesion, Ileus, Small bowel obstruction
Plan
| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
|
| The authors declare no conflicts of interest. |
Vol 212 - N° 3
P. 527-536 - septembre 2016 Retour au numéro
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