title: Laparoscopic colorectal surgery in patients with prior abdominal surgery.
abstract: OBJECTIVE
  We retrospectively investigated the impact of prior abdominal surgery on the outcome of laparoscopic colorectal surgery.
  
  
  METHODS
  Among 607 colorectal cancer patients who underwent laparoscopic surgery, 192 patients had previously undergone abdominal surgery (S group) and 415 had not (non-S group).
  
  
  RESULTS
  The percentage of female patients was higher in the S group than in the non-S group. The incidence of conversion to open surgery was higher in the S group (5.2%, 10/192) than in the non-S group (2.6%, 11/415), but the difference was not significant (p = 0.108). Although the mean operating time and estimated blood loss were similar in the two groups, right and transverse colectomy after prior gastrectomy and ipsilateral colectomy after prior colectomy took longer and were associated with greater blood loss. The morbidity rates of the two groups were similar (S group: 15.6%, 30/192; non-S group: 14.5%, 60/415). There were 5 intraoperative small-bowel injuries or postoperative small-bowel perforations in the S group, especially in the patients with prior gastrointestinal-tract surgery.
  
  
  CONCLUSIONS
  Our findings suggest that there is no reason to avoid laparoscopic procedures in most patients with prior abdominal surgery despite a higher conversion rate, but caution is warranted in patients who have undergone major gastrointestinal-tract surgery.
authors.affiliation: Department of Surgery, Bell-land General Hospital, Sakai, Japan. YosukeF@aol.com
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fukunaga
authors.forename: Masao
authors.initials: M
authors.lastname: Kameyama
authors.forename: Masayasu
authors.initials: M
authors.lastname: Kawasaki
authors.forename: Masashi
authors.initials: M
authors.lastname: Takemura
authors.forename: Yushi
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D016063:Blood Loss, Surgical; D001810:Blood Volume; D015179:Colorectal Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007416:Intestinal Perforation / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors