title: Impact of previous abdominal surgery on the outcome of laparoscopic resection for colorectal cancer: a case-control study in 756 patients.
abstract: BACKGROUND
  A history of previous abdominal surgery (PAS) may increase the complexity of laparoscopic colorectal surgery. The aim of this study was to investigate the impact of PAS on the outcomes of laparoscopic colorectal resection for colorectal cancer.
  
  
  METHODS
  A total of 378 colorectal cancer patients (group A) with a history of PAS were 1:1 matched to 378 controls (group B) without PAS from our prospective laparoscopic colorectal surgery database. The two groups were matched for age, gender, body mass index, American Society of Anesthesiology score, tumor location, type of surgical procedure, and tumor stage.
  
  
  RESULTS
  Patients in the two groups were well balanced with respect to baseline demographic and clinical characteristics. Group A was associated with significantly longer median operating time (220 versus 200 min; P = 0.002). Conversion rate in group A (63/378, 16.67%) was almost twice as high as that in group B (36/378, 9.55%; P = 0.004). Conversions caused by adhesion were more common in patients with a history of PAS (55.56% [35/63] versus 27.78% [10/36], P = 0.008). Postoperative recovery time, length of postoperative hospital stay, perioperative mortality and morbidity rate, lymph nodes harvested, circumferential resection margin positive rate, 3-y disease-free survival, and overall survival rate were not significantly different between the two groups.
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery for colorectal cancer patients with PAS is time consuming, but the incidence of a successfully completed laparoscopic colorectal resection remains high, and the short- and long-term outcomes are not affected by PAS.
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Wei-Gen
authors.initials: WG
authors.lastname: Zeng
authors.affiliation: Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Meng-Jia
authors.initials: MJ
authors.lastname: Liu
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. Electronic address: zhzhxpumc@163.com.
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Zhou
authors.affiliation: The Overall Planning Office, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Hui-Rong
authors.initials: HR
authors.lastname: Hou
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Liang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Xing-Mao
authors.initials: XM
authors.lastname: Zhang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Hu
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D016896:Treatment Outcome
keywords: Colorectal cancer; Conversion; Laparoscopic colorectal resection; Morbidity; Mortality; Previous abdominal surgery