Shintaro Kohama, Masaki Fukunaga, Kunihiko Nagakari, Yoshito Iida, Seiichiro Yoshikawa, Masakazu Ouchi, Kazuhiro Takehara, Yuu Gyoda, Kunpei Honjo, Daisuke Azuma, Yoshinori Kohira, Jun Nomoto, Hirotaka Momose. Department of Surgery, Juntendo Urayasu Hospital
Background: We adopt laparoscopic colectomy for all colorectal cancer since we have introduced in 1993. To assess the safety of laparoscopic colectomy, we retrospectively examined surgical cases of postoperative small bowel obstruction.
1861 colorectal cancer patients underwent laparoscopic colectomy between January 2000 and September 2016 in our department. Among them, cases where surgery was required for treatment of postoperative small bowel obstruction were examined in this study. Postoperative small bowel obstruction which developed during hospital stay was defined as early bowel obstruction, and that which developed after discharge was defined as late bowel obstruction.
Cases of bowel obstruction caused by colorectal cancer recurrence and progression were excluded. 9 surgical cases (0.48%) were considered to be early bowel obstruction and 15 (0.81%) were classified as late bowel obstruction. Left hemicolectomy (n=4, 3.03%) was a significantly more frequent procedure in early bowel obstruction, and abdominoperineal resection (n=5, 4.20%) was significantly more common in late bowel obstruction (p<0.05). Both early and late bowel obstruction included adhesive small bowel obstruction (n=19), internal hernia (n=3), and strangulation obstruction (n=2). Internal hernia (n=3) and strangulation obstruction (n=2) occurred after left hemicolectomy and abdominoperineal resection, respectively. There is no apparent relationship between surgical procedures and adhesion regions (abdominal wall, intestinal tract, and pelvic cavity).
The incidence rate of postoperative small bowel obstruction remained low, and laparoscopic colectomy had been safely performed. However, countermeasures are needed because of the high frequency of both early and late bowel obstruction which occurred after left hemicolectomy and abdominoperineal resection, respectively.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86923
Program Number: P209
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster