Lower Risk for Bowel Obstruction With Less Invasive Surgery: Study
Swedish researchers compared open surgery with laparoscopy
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Friday, April 20, 2012
Small-bowel obstruction -- a blockage in the small intestines -- can develop within days of surgery as a result of scar tissue formation and is a common reason for emergency admission to a hospital.
In this study, Swedish researchers examined the incidence of small-bowel obstruction in more than 108,000 patients who had abdominal or pelvic surgery such as gallbladder surgery, hysterectomy, appendix removal or weight-loss surgery.
The patients were followed for up to five years after surgery or until death. The incidence of small bowel obstruction ranged from 0.4 percent to nearly 14 percent, depending on the type of surgery. Patients who underwent open surgery appeared at least four times more likely to develop small-bowel obstruction than those who had laparoscopic surgery.
The study appears in the April issue of the Archives of Surgery.
"This study shows that, beyond important factors such as age, previous abdominal surgery and comorbidity [coexisting illnesses], the surgical technique is the most important factor related to [small-bowel obstruction]," concluded Dr. Eva Angenete, of Sahlgrenska University Hospital, and colleagues in a journal news release.
"For surgeons, [the study] highlights another potential benefit of minimally invasive surgery and challenges us to continue to offer less invasive procedures whenever they are feasible. For payers and health care policy leaders, it suggests that substantial cost savings could be achieved if open surgery were replaced with laparoscopic surgery more often," Dr. Luke Funk and Dr. Stanley Ashley, of Brigham and Women's Hospital, Harvard Medical School, Boston, wrote in an accompanying journal editorial.
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