title: Does prior abdominal surgery influence conversion rates and outcomes of laparoscopic right colectomy in patients with neoplasia?
abstract: 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.
authors.affiliation: Department of Surgery, New York-Presbyterian Hospital, New York, New York, USA.
authors.forename: Anaeze C
authors.initials: AC
authors.lastname: Offodile
authors.forename: Sang W
authors.initials: SW
authors.lastname: Lee
authors.forename: James
authors.initials: J
authors.lastname: Yoo
authors.forename: Richard L
authors.initials: RL
authors.lastname: Whelan
authors.forename: Dovid
authors.initials: D
authors.lastname: Moradi
authors.forename: Raymond
authors.initials: R
authors.lastname: Baxter
authors.forename: Tracey D
authors.initials: TD
authors.lastname: Arnell
authors.forename: Abu
authors.initials: A
authors.lastname: Nasar
authors.forename: Toyooki
authors.initials: T
authors.lastname: Sonoda
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Milsom
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Feingold
mesh_terms: 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