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  • Title: Adhesive small bowel obstruction after laparoscopic and open colorectal surgery: a systematic review and meta-analysis.
    Author: Ha GW, Lee MR, Kim JH.
    Journal: Am J Surg; 2016 Sep; 212(3):527-36. PubMed ID: 27427294.
    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.
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