title: Bowel obstruction after laparoscopic and open colon resection for cancer: results of 5 years of follow-up in a randomized trial.
abstract: BACKGROUND
  Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared.
  
  
  METHODS
  A retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery.
  
  
  RESULTS
  Baseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant.
  
  
  CONCLUSIONS
  This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.
authors.affiliation: Department of Surgery, Område 2, Sahlgrenska University Hospital/Östra, SE-416 85 Göteborg, Sweden.
authors.forename: Johnna
authors.initials: J
authors.lastname: Schölin
authors.forename: Mark
authors.initials: M
authors.lastname: Buunen
authors.forename: Wim
authors.initials: W
authors.lastname: Hop
authors.forename: Jaap
authors.initials: J
authors.lastname: Bonjer
authors.forename: Bo
authors.initials: B
authors.lastname: Anderberg
authors.forename: Miguel
authors.initials: M
authors.lastname: Cuesta
authors.forename: Salvadora
authors.initials: S
authors.lastname: Delgado
authors.forename: Ainitze
authors.initials: A
authors.lastname: Ibarzabal
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Ivarsson
authors.forename: Martin
authors.initials: M
authors.lastname: Janson
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacy
authors.forename: Johan
authors.initials: J
authors.lastname: Lange
authors.forename: Lars
authors.initials: L
authors.lastname: Påhlman
authors.forename: Stefan
authors.initials: S
authors.lastname: Skullman
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003082:Colectomy / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D000267:Tissue Adhesions / Q000209:etiology*; D016896:Treatment Outcome