A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center.

Stephen W. Davies, Jake R. Gillen, Christopher A. Guidry, Timothy E. Newhook, Nicolas H. Pope, Tjasa Hranjec, Robert G. Sawyer, Peter T. Hallowell

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Laparotomy has been the favored approach regarding surgical management of small bowel obstruction (SBO); however, laparoscopy may offer improved outcomes. Patients undergoing laparoscopic lysis of adhesions (LOA) at our institution for SBO will have lower postoperative morbidity and 30-day mortality. Patients undergoing LOA at our institution, from 2000 to 2011, were reviewed. Categorical data were analyzed with χ(2) or Fisher's exact tests. Continuous data were analyzed with Student's t test or Wilcoxon rank sum. One hundred two (38 laparoscopic, 64 open) LOA cases were selected. Perioperative contamination and conservative management were higher in the open group. Open cases had a greater incidence of intensive care unit (ICU) admissions and longer length of stay. Stratified analysis determined a strong association between perioperative contamination and a higher incidence of ICU admission, perioperative contamination and longer LOS, and conservative management and longer LOS. Finally, patient outcome did not differ between those treated by surgeons trained in minimally invasive surgery (MIS) compared with those not trained in MIS. Careful consideration of surgical approach and timing is called for in all patients with SBO; however, whenever possible, laparoscopic preference should be given to most patients in an expeditious fashion irrespective of MIS training.

Original languageEnglish (US)
Pages (from-to)261-269
Number of pages9
JournalThe American surgeon
Volume80
Issue number3
StatePublished - 2014

Fingerprint

Tertiary Care Centers
Minimally Invasive Surgical Procedures
Intensive Care Units
Incidence
Nonparametric Statistics
Laparoscopy
Laparotomy
Length of Stay
Students
Morbidity
Mortality
Conservative Treatment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Davies, S. W., Gillen, J. R., Guidry, C. A., Newhook, T. E., Pope, N. H., Hranjec, T., ... Hallowell, P. T. (2014). A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center. The American surgeon, 80(3), 261-269.

A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center. / Davies, Stephen W.; Gillen, Jake R.; Guidry, Christopher A.; Newhook, Timothy E.; Pope, Nicolas H.; Hranjec, Tjasa; Sawyer, Robert G.; Hallowell, Peter T.

In: The American surgeon, Vol. 80, No. 3, 2014, p. 261-269.

Research output: Contribution to journalArticle

Davies, SW, Gillen, JR, Guidry, CA, Newhook, TE, Pope, NH, Hranjec, T, Sawyer, RG & Hallowell, PT 2014, 'A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center.', The American surgeon, vol. 80, no. 3, pp. 261-269.
Davies SW, Gillen JR, Guidry CA, Newhook TE, Pope NH, Hranjec T et al. A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center. The American surgeon. 2014;80(3):261-269.
Davies, Stephen W. ; Gillen, Jake R. ; Guidry, Christopher A. ; Newhook, Timothy E. ; Pope, Nicolas H. ; Hranjec, Tjasa ; Sawyer, Robert G. ; Hallowell, Peter T. / A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center. In: The American surgeon. 2014 ; Vol. 80, No. 3. pp. 261-269.
@article{b73656fd870e461e96de6490b5bd725a,
title = "A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center.",
abstract = "Laparotomy has been the favored approach regarding surgical management of small bowel obstruction (SBO); however, laparoscopy may offer improved outcomes. Patients undergoing laparoscopic lysis of adhesions (LOA) at our institution for SBO will have lower postoperative morbidity and 30-day mortality. Patients undergoing LOA at our institution, from 2000 to 2011, were reviewed. Categorical data were analyzed with χ(2) or Fisher's exact tests. Continuous data were analyzed with Student's t test or Wilcoxon rank sum. One hundred two (38 laparoscopic, 64 open) LOA cases were selected. Perioperative contamination and conservative management were higher in the open group. Open cases had a greater incidence of intensive care unit (ICU) admissions and longer length of stay. Stratified analysis determined a strong association between perioperative contamination and a higher incidence of ICU admission, perioperative contamination and longer LOS, and conservative management and longer LOS. Finally, patient outcome did not differ between those treated by surgeons trained in minimally invasive surgery (MIS) compared with those not trained in MIS. Careful consideration of surgical approach and timing is called for in all patients with SBO; however, whenever possible, laparoscopic preference should be given to most patients in an expeditious fashion irrespective of MIS training.",
author = "Davies, {Stephen W.} and Gillen, {Jake R.} and Guidry, {Christopher A.} and Newhook, {Timothy E.} and Pope, {Nicolas H.} and Tjasa Hranjec and Sawyer, {Robert G.} and Hallowell, {Peter T.}",
year = "2014",
language = "English (US)",
volume = "80",
pages = "261--269",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "3",

}

TY - JOUR

T1 - A comparative analysis between laparoscopic and open adhesiolysis at a tertiary care center.

AU - Davies, Stephen W.

AU - Gillen, Jake R.

AU - Guidry, Christopher A.

AU - Newhook, Timothy E.

AU - Pope, Nicolas H.

AU - Hranjec, Tjasa

AU - Sawyer, Robert G.

AU - Hallowell, Peter T.

PY - 2014

Y1 - 2014

N2 - Laparotomy has been the favored approach regarding surgical management of small bowel obstruction (SBO); however, laparoscopy may offer improved outcomes. Patients undergoing laparoscopic lysis of adhesions (LOA) at our institution for SBO will have lower postoperative morbidity and 30-day mortality. Patients undergoing LOA at our institution, from 2000 to 2011, were reviewed. Categorical data were analyzed with χ(2) or Fisher's exact tests. Continuous data were analyzed with Student's t test or Wilcoxon rank sum. One hundred two (38 laparoscopic, 64 open) LOA cases were selected. Perioperative contamination and conservative management were higher in the open group. Open cases had a greater incidence of intensive care unit (ICU) admissions and longer length of stay. Stratified analysis determined a strong association between perioperative contamination and a higher incidence of ICU admission, perioperative contamination and longer LOS, and conservative management and longer LOS. Finally, patient outcome did not differ between those treated by surgeons trained in minimally invasive surgery (MIS) compared with those not trained in MIS. Careful consideration of surgical approach and timing is called for in all patients with SBO; however, whenever possible, laparoscopic preference should be given to most patients in an expeditious fashion irrespective of MIS training.

AB - Laparotomy has been the favored approach regarding surgical management of small bowel obstruction (SBO); however, laparoscopy may offer improved outcomes. Patients undergoing laparoscopic lysis of adhesions (LOA) at our institution for SBO will have lower postoperative morbidity and 30-day mortality. Patients undergoing LOA at our institution, from 2000 to 2011, were reviewed. Categorical data were analyzed with χ(2) or Fisher's exact tests. Continuous data were analyzed with Student's t test or Wilcoxon rank sum. One hundred two (38 laparoscopic, 64 open) LOA cases were selected. Perioperative contamination and conservative management were higher in the open group. Open cases had a greater incidence of intensive care unit (ICU) admissions and longer length of stay. Stratified analysis determined a strong association between perioperative contamination and a higher incidence of ICU admission, perioperative contamination and longer LOS, and conservative management and longer LOS. Finally, patient outcome did not differ between those treated by surgeons trained in minimally invasive surgery (MIS) compared with those not trained in MIS. Careful consideration of surgical approach and timing is called for in all patients with SBO; however, whenever possible, laparoscopic preference should be given to most patients in an expeditious fashion irrespective of MIS training.

UR - http://www.scopus.com/inward/record.url?scp=84900817154&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84900817154&partnerID=8YFLogxK

M3 - Article

VL - 80

SP - 261

EP - 269

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 3

ER -