title: Effect of laparoscopy on the risk of small-bowel obstruction: a population-based register study.
abstract: OBJECTIVE
  To investigate the incidence and risk factors for small-bowel obstruction (SBO) after certain surgical procedures.
  
  
  METHODS
  A population-based retrospective register study.
  
  
  METHODS
  Small-bowel obstruction causes considerable patient suffering. Risk factors for SBO have been identified, but the effect of surgical technique (open vs laparoscopic) on the incidence of SBO has not been fully elucidated.
  
  
  METHODS
  The Inpatient Register held by the Swedish National Board of Health and Welfare was used. The hospital discharge diagnoses and registered performed surgical procedures identified data for cholecystectomy, hysterectomy, salpingo-oophorectomy, bowel resection, anterior resection, abdominoperineal resection, rectopexy, appendectomy, and bariatric surgery performed from January 1, 2002, through December 31, 2004. Data on demographic characteristics, comorbidity, previous abdominal surgery, and death were collected.
  
  
  METHODS
  Episodes of hospital stay and surgery for SBO within 5 years after the index surgery.
  
  
  RESULTS
  A total of 108,141 patients were included. The incidence of SBO ranged from 0.4% to 13.9%. Multivariate analysis revealed age, previous surgery, comorbidity, and surgical technique to be risk factors for SBO. Laparoscopy exceeded other risk factors in reduction of the risk of SBO for most of the surgical procedures.
  
  
  CONCLUSIONS
  Open surgery seems to increase the risk of SBO at least 4 times compared with laparoscopy for most of the abdominal surgical procedures studied. Other factors such as age, previous abdominal surgery, and comorbidity are also of importance.
authors.affiliation: Department of Surgery, Sahlgrenska University Hospital/Östra, 416 85 Gothenburg, Sweden. eva.angenete@vgregion.se
authors.forename: Eva
authors.initials: E
authors.lastname: Angenete
authors.forename: Anders
authors.initials: A
authors.lastname: Jacobsson
authors.forename: Martin
authors.initials: M
authors.lastname: Gellerstedt
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology*; D007421:Intestine, Small; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology