title: The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer.
abstract: BACKGROUND
  Early postoperative small bowel obstruction is associated with considerable morbidity and mortality but has not been well documented in the era of laparoscopic surgery for colorectal cancer.
  
  
  METHODS
  Consecutive patients who had undergone laparoscopic resection for colorectal cancer were studied.
  
  
  RESULTS
  In total, 1787 patients (105 with and 1682 without early postoperative small bowel obstruction) with colorectal cancer requiring laparoscopic colorectal surgery were evaluated in this study. Ten patients (0.56% among the total patient population, 9.5% among patients who experienced early postoperative small bowel obstruction) who did not respond to conservative treatment for more than 14 days required surgical intervention. Multivariate analysis showed that male sex (adjusted odds ratio [AOR]=2.27), combined operation (AOR=2.23), and diverting stoma (AOR=4.79) were associated with a higher early postoperative small bowel obstruction rate. For factors related to surgical difficulty, open conversion (AOR=2.85), blood transfusion (AOR=3.51), and an operation time longer than 180 minutes (AOR=1.91) were independent factors associated with an increased early postoperative small bowel obstruction rate.
  
  
  CONCLUSIONS
  Early postoperative small bowel obstruction following laparoscopic resection for colorectal cancer occurred in 5.9% of patients. Factors for predicting the development of early postoperative small bowel obstruction in patients with colorectal cancer are variables reflective of a more difficult surgery, rather than pathologic disease severity or anatomical location. In addition, most patients with early postoperative small bowel obstruction improved with conservative treatment, and surgical treatment was rarely needed.
authors: 1 Department of Surgery, Chonnam National University Hwasun Hospital and Medical School , Gwangju, Korea.
authors: Chang Hyun
authors: CH
authors: Kim
authors: Jae Kyun
authors: JK
authors: Joo
authors: Hyeong Rok
authors: HR
authors: Kim
authors: Young Jin
authors: YJ
authors: Kim
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors