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.
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.
Keywords
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Article info
Publication history
Published online: May 09, 2016
Received in revised form:
February 13,
2016
Received:
November 29,
2015
Footnotes
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.
Identification
Copyright
© 2016 Published by Elsevier Inc.
