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Am J Surg. 2013 Aug;206(2):166-71. doi: 10.1016/j.amjsurg.2013.01.018. Epub 2013 Apr 3.

The impact of adhesions on operations and postoperative recovery in colon cancer surgery.

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1
Division of General Surgery and Gastrointestinal Surgery, Harvard Medical School/Massachusetts General Hospital, Boston, MA 02114, USA.

Abstract

BACKGROUND:

Many surgeons assume that adhesions encountered during surgery negatively influence surgical outcomes. This article attempts to assess the role adhesions have on outcomes of colon cancer surgery.

METHODS:

Records of 1,071 consecutive patients operated for colonic adenocarcinoma (2004-2011) were reviewed. Patients were assigned to 3 groups: no adhesions, any adhesions, or dense adhesions. Multivariate regression assessed the association between adhesions and the duration of surgery and stay as well as laparoscopic conversion and complication rates.

RESULTS:

Adhesions were encountered in 329 (30.7%) patients; 138 (12.8%) had dense adhesions. After correction for age and comorbidities, having adhesions was associated with longer surgeries (P < .001), longer hospital stays (P = .029), a borderline significantly higher conversion rate (P = .058), and a delayed return of bowel function (P = .037). Dense adhesions had stronger associations with surgical duration (P < .001), stay duration (P < .001), and conversion (P < .001).

CONCLUSIONS:

Abdominal adhesions independently put patients at risk for a longer and more complicated perioperative stay after colon cancer surgery.

KEYWORDS:

Colon cancer; Complications; Intra-abdominal adhesions; Stay duration; Surgery duration

PMID:
23561641
DOI:
10.1016/j.amjsurg.2013.01.018
[Indexed for MEDLINE]
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