Society of Black Academic SurgeonsOpen abdominal surgery: a risk factor for future laparoscopic surgery?
Section snippets
Methods
We used data from the American College of Surgeons National Surgical Quality Improvement Program (2005 to 2009) databases. The American College of Surgeons National Surgical Quality Improvement Program collects data on preoperative risk factors, intraoperative characteristics, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures in both inpatient and outpatient settings at participating hospitals.
Using the American Medical Association's
Results
A total of 162,415 patients were studied. The majority was female (67.3%). Whites accounted for 69% of the population, Hispanic 9.9%, Blacks 9.5%, and 8.4% lacked ethnicity data. The majority of patients were between the ages of 25 and 64 years (76.9%). Over 90% (91.5%) of the study population was overweight or obese; 18.1% were smokers. Additionally, 34.8% had pre-existing cardiovascular disease and 1.9% had pulmonary disease, while .4% suffered from renal disease. The most common laparoscopic
Comments
The results derived from our analysis were not surprising. Most surgeons would agree that adhesions do complicate otherwise “routine” procedures and as such warrant extra care and attention. The details of these complications are not well described in the literature however, and this provided the impetus for our study. Much of the established data reaffirmed the consequences of adhesions following surgery with respect to bowel obstruction.5, 8, 9 Indeed, readmission for bowel obstruction
Conclusion
The analysis of the data regarding complications during laparoscopic surgery following previous open abdominal surgery was performed using a proxy devised specifically for this study. Despite the limitations of our methodology, we advocate its validity. Our results show that previous open surgery complicates future laparoscopic surgery by increasing the incidence of postoperative complications as well as increasing the operating time and overall LOS for patients.
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The authors declare no conflicts of interest.