Does prior abdominal surgery influence conversion rates and outcomes of laparoscopic right colectomy in patients with neoplasia?
OBJECTIVE
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.
Offodile
Anaeze C
AC
Department of Surgery, New York-Presbyterian Hospital, New York, New York, USA.
Lee
Sang W
SW
Yoo
James
J
Whelan
Richard L
RL
Moradi
Dovid
D
Baxter
Raymond
R
Arnell
Tracey D
TD
Nasar
Abu
A
Sonoda
Toyooki
T
Milsom
Jeffrey W
JW
Feingold
Daniel L
DL
D000005:Abdomen / Q000601:surgery*; D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome