Early postoperative XXXX : open vs laparoscopic.

@entity1 @entity5 @entity1744 @entity66
BACKGROUND: The window for safe reoperation in early postoperative (<6  weeks) @entity1744 (ESBO) is short and intimately dependent on elapsed time from the initial operation. Laparoscopic procedures create fewer inflammatory changes than open laparotomies. We hypothesize that it is safer to reoperate for ESBO after laparoscopic procedures than open. METHODS: Review of @entity1 who underwent re-exploration for ESBO from 2003 to 2009 was performed. Based on the initial operation, @entity1 were classified as "open" or "laparoscopic." The Revised Accordion Severity Grading System was used to define complications as minor (1 to 2) or severe (3 to 6). RESULTS: There were 189 @entity1 identified (age 55  years, 48% male): 130 open and 59 laparoscopic. @entity66 was more common (65% vs 42%, P < .01), while strictures were less frequent (5% vs 14% P = .03), in the open group. The open group had a greater rate of @entity5 , days to re-exploration, and severity of complications. There was no difference in the rates of minor complications, enterotomy, and mortality. ESBO after laparoscopic surgery was more commonly caused by a focal source (85% vs 63%). Eighty-three @entity1 (64 open, 19 laparoscopic) underwent re-exploration at or beyond 14  days. Within this subgroup, there were more severe complications (25% vs 5%) after open procedures with equivalent mortality (4% vs 0%). CONCLUSIONS: Laparoscopic approaches confer a lower rate of adhesive disease and severity of complications in early SBO as compared with open surgery even if performed after 2  weeks of index procedure.
