title: A systematic review comparing laparoscopic vs open adhesiolysis in patients with adhesional small bowel obstruction.
abstract: OBJECTIVE
  To evaluate whether surgical outcomes differ between laparoscopic vs open approach for adhesiolysis in patients presenting with adhesional small bowel obstruction (ASBO).
  
  
  METHODS
  A systematic review of literature on published studies reporting the surgical outcomes after laparoscopic vs open adhesiolysis for ASBO was undertaken using the principles of meta-analysis.
  
  
  RESULTS
  Fourteen comparative studies on 38,057 patients, evaluating the surgical outcomes in patients undergoing laparoscopic vs open adhesiolysis for ASBO were analyzed. Laparoscopic adhesiolysis resulted in the reduced risk of morbidity (P < .00001), mortality (P < .0001), and surgical infections (P = .003). In addition, the risk of respiratory complications, cardiac complications, bowel resection, and venous thromboembolism was lower with shorter hospitalization in laparoscopic adhesiolysis group. However, statistical equivalence was seen in variables of duration of operation and iatrogenic enterotomies.
  
  
  CONCLUSIONS
  Laparoscopic adhesiolysis for ASBO seems to have clinically proven advantage over open approach.
authors.affiliation: Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK. Electronic address: surgeon1wrh@hotmail.com.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Sajid
authors.affiliation: Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Khawaja
authors.affiliation: Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK.
authors.forename: Parv
authors.initials: P
authors.lastname: Sains
authors.affiliation: Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK.
authors.forename: Krishna K
authors.initials: KK
authors.lastname: Singh
authors.affiliation: Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK.
authors.forename: Mirza K
authors.initials: MK
authors.lastname: Baig
mesh_terms: D000368:Aged; D002423:Cause of Death; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Adhesiolysis; Adhesions; Enterotomy; Laparoscopy; Laparotomy