A study in the April issue of Archives of Surgery, demonstrates that in comparison with laparoscopic surgery, open surgery seems to be linked to a higher risk of small-bowel obstruction (SBO).

The researchers state in their study background that SBO is a common reason for emergency admission. One of SBO’s major causes are intraperitoneal or abdominal adhesions, which can develop from peritoneal trauma, for instance before abdominal surgery and develop within days of a surgical procedure.

The researchers state: “Laparoscopic surgery is considered to be associated with less surgical trauma, implying a reduction of adhesions”, but point out that study literature on the clinical effect of laparoscopy on adhesion-related morbidity has not been convincing.

In a population-based register study, which included procedures from January 2002 to December 2004, using the Swedish National Board of Health and Welfare’s Inpatient Register, Eva Angenete, M.D., Ph.D., of the Sahlgrenska University Hospital/Ostra in Gothenburg, Sweden, and her team evaluated the percentage of SBO incidents that occurred after abdominal and pelvic surgery for various common surgical and gynecological conditions in 108,141 patients, in order to identify potential SBO risk factors. The surgical procedures included appendectomy (appendix removal) and bariatric surgery, including gastric bypass cholecystectomy (gall bladder removal) and hysterectomy (uterus removal).

The follow-up was up to five years after the initial surgery or until death and the study outcome demonstrated that depending on the type of surgical procedure, the incidence of SBO ranged from 0.4% to 13.9%.

The researchers conclude:

“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 SBO. Compared with laparoscopic surgery, open surgery seems to increase the risk of SBO at least four times.”

Written By Petra Rattue