LAPAROSCOPIC VERSUS OPEN SURGERY FOR ACUTE ADHESIVE SMALL-BOWEL OBSTRUCTION : A PROPENSITY SCORE-MATCHED ANALYSIS

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dc.contributor.author Hackenberg, T.
dc.contributor.author Mentula, P.
dc.contributor.author Leppaniemi, A.
dc.contributor.author Sallinen, V.
dc.date.accessioned 2018-06-27T21:21:03Z
dc.date.available 2021-12-17T22:02:14Z
dc.date.issued 2017-03
dc.identifier.citation Hackenberg , T , Mentula , P , Leppaniemi , A & Sallinen , V 2017 , ' LAPAROSCOPIC VERSUS OPEN SURGERY FOR ACUTE ADHESIVE SMALL-BOWEL OBSTRUCTION : A PROPENSITY SCORE-MATCHED ANALYSIS ' , Scandinavian Journal of Surgery , vol. 106 , no. 1 , pp. 28-33 . https://doi.org/10.1177/1457496916641341
dc.identifier.other PURE: 86068068
dc.identifier.other PURE UUID: e7de8707-4e69-4d75-b55b-7de6d5cf78e8
dc.identifier.other WOS: 000398818200003
dc.identifier.other Scopus: 85013249514
dc.identifier.uri http://hdl.handle.net/10138/236700
dc.description.abstract Background and Aims: The laparoscopic approach has been increasingly used to treat adhesive small-bowel obstruction. The aim of this study was to compare the outcomes of a laparoscopic versus an open approach for adhesive small-bowel obstruction. Material and Methods: Data were retrospectively collected on patients who had surgery for adhesive small-bowel obstruction at a single academic center between January 2010 and December 2012. Patients with a contraindication for the laparoscopic approach were excluded. A propensity score was used to match patients in the laparoscopic and open surgery groups based on their preoperative parameters. Results: A total of 25 patients underwent laparoscopic adhesiolysis and 67 patients open adhesiolysis. The open adhesiolysis group had more suspected bowel strangulations and more previous abdominal surgeries than the laparoscopic adhesiolysis group. Severe complication rate (Clavien-Dindo 3 or higher) was 0% in the laparoscopic adhesiolysis group versus 14% in the open adhesiolysis group (p = 0.052). Twenty-five propensity score-matched patients from the open adhesiolysis group were similar to laparoscopic adhesiolysis group patients with regard to their preoperative parameters. Length of hospital stay was shorter in the laparoscopic adhesiolysis group compared to the propensity score-matched open adhesiolysis group (6.0 vs 10.0 days, p = 0.037), but no differences were found in severe complications between the laparoscopic adhesiolysis and propensity score-matched open adhesiolysis groups (0% vs 4%, p = 0.31). Conclusion: Patients selected to be operated by the open approach had higher preoperative morbidity than the ones selected for the laparoscopic approach. After matching for this disparity, the laparoscopic approach was associated with a shorter length of hospital stay without differences in complications. The laparoscopic approach may be a preferable approach in selected patients. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Scandinavian Journal of Surgery
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Laparoscopy
dc.subject small-bowel obstruction
dc.subject randomized controlled trial
dc.subject adhesiolysis
dc.subject complication
dc.subject retrospective
dc.subject emergency
dc.subject acute abdomen
dc.subject OPEN SURGICAL-MANAGEMENT
dc.subject OPEN ADHESIOLYSIS
dc.subject LAPAROTOMY
dc.subject OUTCOMES
dc.subject TRIAL
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title LAPAROSCOPIC VERSUS OPEN SURGERY FOR ACUTE ADHESIVE SMALL-BOWEL OBSTRUCTION : A PROPENSITY SCORE-MATCHED ANALYSIS en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Department of Surgery
dc.contributor.organization II kirurgian klinikka
dc.contributor.organization University of Helsinki
dc.contributor.organization Pertti Panula / Principal Investigator
dc.contributor.organization IV kirurgian klinikka
dc.contributor.organization HUS Abdominal Center
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1177/1457496916641341
dc.relation.issn 1457-4969
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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