Adhesive small bowel obstruction after laparoscopic and open colorectal surgery: a systematic review and meta-analysis

Am J Surg. 2016 Sep;212(3):527-36. doi: 10.1016/j.amjsurg.2016.02.019. Epub 2016 May 10.

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, I(2)=41%) and nonrandomized studies (RR .49, 95% CI .32 to .76, I(2)=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, I(2)=0%) and nonrandomized studies (RR .56, 95% CI .33 to .94, I(2)=77%).

Conclusions: Laparoscopic colorectal surgery significantly reduced the rates of adhesive SBO and subsequent surgery for adhesive SBO, compared with open surgery.

Keywords: Adhesion; Colorectal surgery; Ileus; Laparoscopy; Small bowel obstruction.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Colorectal Surgery / adverse effects*
  • Humans
  • Intestinal Obstruction / etiology*
  • Intestine, Small*
  • Laparoscopy / adverse effects*
  • Postoperative Complications*
  • Tissue Adhesions / etiology*