Figueiredo MN, Campos FG, D’Albuquerque LA, Nahas SC, Cecconello I, Panis Y. Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review. World J Gastrointest Surg 2016; 8(7): 533-540 [PMID: 27462396 DOI: 10.4240/wjgs.v8.i7.533]
Corresponding Author of This Article
Marleny Novaes Figueiredo, MD, Department of Gastroenterology, University of São Paulo Medical School, Rua Padre João Manuel, 222 Cj 120, São Paulo 01246-904, Brazil. nynovaes@usp.br
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2016; 8(7): 533-540 Published online Jul 27, 2016. doi: 10.4240/wjgs.v8.i7.533
Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review
Marleny Novaes Figueiredo, Fabio Guilherme Campos, Luiz Augusto D’Albuquerque, Sergio Carlos Nahas, Ivan Cecconello, Yves Panis
Marleny Novaes Figueiredo, Department of Gastroenterology, University of São Paulo Medical School, São Paulo 01246-904, Brazil
Fabio Guilherme Campos, Sergio Carlos Nahas, Division of Colorectal Surgery, Department of Gastroenterology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo 01246-904, Brazil
Luiz Augusto D’Albuquerque, Ivan Cecconello, Department of Gastroenterology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo 01246-904, Brazil
Yves Panis, Department of Colorectal Surgery, Pôle des Maladies de l’Appareil Digestif (PMAD), 92110 Clichy, France
Author contributions: Figueiredo MN and Campos FG designed the study and performed literature search and article selection; Figueiredo MN and Panis Y statisctical analysis and writing; D’Albuquerque LA, Nahas SC and Cecconello I revision of data collected, writing and editing.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Data sharing statement: No data were created. The data from selected studies are available as well as selected data collected for this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marleny Novaes Figueiredo, MD, Department of Gastroenterology, University of São Paulo Medical School, Rua Padre João Manuel, 222 Cj 120, São Paulo 01246-904, Brazil. nynovaes@usp.br
Telephone: +55-11-980804467 Fax: +55-11-30647010
Received: October 20, 2015 Peer-review started: October 21, 2015 First decision: December 28, 2015 Revised: April 2, 2016 Accepted: April 14, 2016 Article in press: April 18, 2016 Published online: July 27, 2016 Processing time: 265 Days and 18.2 Hours
Abstract
AIM: To perform a systematic review focusing on short-term outcomes after colorectal surgery in patients with previous abdominal open surgery (PAOS).
METHODS: A broad literature search was performed with the terms “colorectal”, “colectomy”, “PAOS”, “previous surgery” and “PAOS”. Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS, whether descriptive or comparative. Endpoints of interest were conversion rates, inadvertent enterotomy and morbidity. Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
RESULTS: From a total of 394 citations, 13 full-texts achieved selection criteria to be included in the study. Twelve of them compared patients with and without PAOS. All studies were retrospective and comparative and two were case-matched. The selected studies comprised a total of 5005 patients, 1865 with PAOS. Among the later, only 294 (16%) had history of a midline incision for previous gastrointestinal surgery. Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopy was more prevalent in 3 of 5 studies that disclosed this event. Morbidity was similar in the majority of studies. A quantitative analysis (meta-analysis) could not be performed due to heterogeneity of the studies.
CONCLUSION: Conversion rates were slightly higher in PAOS groups, although not statistical significant in most studies. History of PAOS did not implicate in higher morbidity rates.
Core tip: So far, there is no substantial evidence in the literature to recommend laparoscopic surgery instead of laparotomy for patients previously submitted to abdominal surgery, concerning short-term benefits, such as conversion rates and morbidity. This review, although without a meta-analysis, brings new light into this matter.
