0065 Endo+Colon Lec. or Poster
LOW INCIDENCE OF ADHESION ILEUS AFTER
LAPAROSCOPIC COLORECTAL SURGERY
Danny Rosin, Oded Zmora, Aviad Hoffman, Marat Khaikin,
Barak Bar Zakai, Yaron Munz, Moshe Shabtai, Amram Ayalon
The Department of General Surgery & Transplantation, Sheba Medical
Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv
Background: Post-operative adhesions are a major cause of morbidity and
medical expenses. Bowel obstruction is attributed to adhesions in nearly 40
percent of cases, many of which are following colon and rectal surgery.
Laparoscopic surgery has the potential advantage of reduced adhesion
formation, due to attenuated surgical trauma, less tissue handling and
smaller scars.
The aim of this study is to assess the rate of adhesion ileus after
laparoscopic colon and rectal surgery.
Methods: Data regarding all cases of laparoscopic colon and rectal surgery
was prospectively collected. Information relative to demographics, surgical
procedures and follow up was analyzed, and patients who were readmitted
for bowel obstruction were identified.
Results: Over a period of 8 years, 306 patients, at a mean age of 66.5 years,
had laparoscopic colon and rectal operation in our department, 122 for
benign conditions and 184 for malignant disease. Mean follow-up was 16
months. Six cases (1.9%) of bowel obstruction, unrelated to hernia or
advanced cancer, were identified. Two patients had a history of open
surgery in addition to the laparoscopic procedure, so adhesions can be
attributed to the laparoscopic procedure in four patients (1.3%). Obstruction
occurred within 2 weeks of surgery in two patients, and one early reoperation was required.
Conclusions: The incidence of adhesion ileus after laparoscopic colon and
rectal surgery appears to be very low. This long-term benefit of laparoscopic
surgery, with its related economic consequences, should be considered, in
addition to the short-term advantages, when comparing this technique to its
open counterpart.