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Invited Critique
Apr 2012

Minimal Invasion and Maximal BenefitComment on “Effect of Laparoscopy on the Risk of Small-Bowel Obstruction”

Author Affiliations

Author Affiliations: Department of General Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Arch Surg. 2012;147(4):365. doi:10.1001/archsurg.2012.157

The short-term benefits of laparoscopy have been well documented over the past 20 years: less postoperative pain, quicker return to baseline function, and shorter hospital stays. This study by Angenete and colleagues1 suggests that the benefits of laparoscopy may extend beyond the immediate postoperative period. Using a robust national database of more than 100 000 patients who were followed up for up to 5 years or until death, the authors found that laparoscopy correlated highly with a reduced incidence of postoperative small-bowel obstruction (SBO) compared with open surgery. This relationship held true for numerous commonly performed procedures including cholecystectomy, hysterectomy, oophorectomy, bowel resection, rectopexy, and appendectomy. The reduction in SBO incidence remained for each of these procedures even after accounting for patient factors such as age, comorbidity, and previous surgery.

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