• Muhammad S Sajid, Amir H Khawaja, Parv Sains, Krishna K Singh, and Mirza K Baig.
• Department of General, Endoscopic & Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, West Sussex BN11 2DH, UK. Electronic address: surgeon1wrh@hotmail.com.
• Am. J. Surg. 2016 Jul 1; 212 (1): 138-50.

Background And ObjectiveTo evaluate whether surgical outcomes differ between laparoscopic vs open approach for adhesiolysis in patients presenting with adhesional small bowel obstruction (ASBO).Data SourceA systematic review of literature on published studies reporting the surgical outcomes after laparoscopic vs open adhesiolysis for ASBO was undertaken using the principles of meta-analysis.ResultsFourteen comparative studies on 38,057 patients, evaluating the surgical outcomes in patients undergoing laparoscopic vs open adhesiolysis for ASBO were analyzed. Laparoscopic adhesiolysis resulted in the reduced risk of morbidity (P < .00001), mortality (P < .0001), and surgical infections (P = .003). In addition, the risk of respiratory complications, cardiac complications, bowel resection, and venous thromboembolism was lower with shorter hospitalization in laparoscopic adhesiolysis group. However, statistical equivalence was seen in variables of duration of operation and iatrogenic enterotomies.ConclusionsLaparoscopic adhesiolysis for ASBO seems to have clinically proven advantage over open approach.Copyright © 2016 Elsevier Inc. All rights reserved.

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