title: Effect of previous abdominal surgery on outcomes following laparoscopic colorectal surgery.
abstract: OBJECTIVE
  The impact of previous abdominal surgeries on the need for conversion to open surgery and on short-term outcomes during/after laparoscopic colectomy was retrospectively investigated.
  
  
  METHODS
  This retrospective cohort study was conducted from December 1996 through December 2009.
  
  
  METHODS
  This study was conducted at Osaka Medical College Hospital.
  
  
  METHODS
  A total of 1701 consecutive patients who had undergone laparoscopic resection of the colon and rectum were classified as not having previous abdominal surgery (n = 1121) or as having previous abdominal surgery (n = 580).
  
  
  METHODS
  Short-term outcomes were recorded, and risk factors for conversion to open surgery were analyzed.
  
  
  RESULTS
  There were no significant differences in operative time, blood loss, number of lymph nodes removed, or conversion rate between the groups. The rate of inadvertent enterotomy was significantly higher in the previous abdominal surgery group than in the not having previous abdominal surgery group (0.9% versus 0.1%; p = 0.03), and the postoperative recovery time was significantly longer in the previous abdominal surgery group than in the not having previous abdominal surgery group. Ileus was more frequent in the previous abdominal surgery group than in the not having previous abdominal surgery group (3.8% versus 2.1%; p = 0.04). Significant risk factors for conversion to open surgery were T stage ≥3 (OR, 2.81; 95% CI, 1.89-3.75), median incision (OR, 4.34; 95% CI, 1.23-9.41), upper median incision (OR, 2.78; 95% CI, 1.29-5.42), lower median incision (OR, 1.82; 95% CI, 1.09-3.12), and transverse colectomy (OR, 1.76; 95% CI, 1.29-2.41).
  
  
  CONCLUSIONS
  The incidence of successfully completed laparoscopic colectomy after previous abdominal surgery remains high, and the short-term outcomes are acceptable.
authors: Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki, Osaka, Japan. sur138@poh.osakamed.ac.jp
authors: Masashi
authors: M
authors: Yamamoto
authors: Junji
authors: J
authors: Okuda
authors: Keitaro
authors: K
authors: Tanaka
authors: Keisaku
authors: K
authors: Kondo
authors: Keiko
authors: K
authors: Asai
authors: Hajime
authors: H
authors: Kayano
authors: Shinsuke
authors: S
authors: Masubuchi
authors: Kazuhisa
authors: K
authors: Uchiyama
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome