title: Adhesive small bowel obstruction after laparoscopic and open colorectal surgery: a systematic review and meta-analysis.
abstract: BACKGROUND
  It is considered that laparoscopic surgery is associated with a much lower rate of postoperative formation of adhesions than open surgery. This meta-analysis assessed the incidence of adhesion-related readmissions and surgery for adhesive small bowel obstruction (SBO) in patients who underwent laparoscopic or open colorectal surgery.
  
  
  METHODS
  Multiple comprehensive databases were searched systematically to identify relevant studies and meta-analysis was done.
  
  
  RESULTS
  Meta-analysis showed that laparoscopic surgery was associated with a lower rate of adhesive SBO, both for randomized clinical trials (relative risk [RR] .26, 95% confidence interval [CI] .10 to .67, I(2)=41%) and nonrandomized studies (RR .49, 95% CI .32 to .76, I(2)=91%). Laparoscopic surgery was also associated with a lower rate of subsequent surgery for adhesive SBO, both for randomized clinical trials (RR .25, 95% CI .06 to .96, I(2)=0%) and nonrandomized studies (RR .56, 95% CI .33 to .94, I(2)=77%).
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery significantly reduced the rates of adhesive SBO and subsequent surgery for adhesive SBO, compared with open surgery.
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Ha
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea. Electronic address: gsminro@jbnu.ac.kr.
authors.forename: Min Ro
authors.initials: MR
authors.lastname: Lee
authors.affiliation: Research Institute of Clinical Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D003107:Colorectal Surgery / Q000009:adverse effects*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D007421:Intestine, Small; D010535:Laparoscopy / Q000009:adverse effects*; D011183:Postoperative Complications; D000267:Tissue Adhesions / Q000209:etiology*
keywords: Adhesion; Colorectal surgery; Ileus; Laparoscopy; Small bowel obstruction