Bowel Obstruction after Laparoscopic and Open Colon Resection for Cancer: Results of 5 Years of Follow-Up in a Randomized Trial

Background Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparo-scopic technique should reduce the risk for adhesion for-mation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared. Methods A retrospective analysis was performed, col-lecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery. Results Baseline characteristics for the evaluated lapa-roscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1 % respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8 % in stage I, 6.6 % in stage II, and 7 % in stage III, but the differences were not significant. Conclusions This analysis does not support the hypoth-esis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery