eP134 - Small Bowel Obstruction After Minimally Invasive Left Colon and Rectal Resections: Does the Approach Matter?

ePoster Presenter(s)

• 

  Devesh S. Ballal, MS, MCh(surgical Oncology)

  Colorectal Fellow
  Advocate Lutheran General Hospital
  Advocate Lutheran General Hospital, Park Ridge, Illinois
  Des Plaines, IL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• SG

  Sheldon Gong, Bachelor of Science

  Medical Student
  Chicago Medical School at Rosalind Franklin University of Medicine and Science
  San Francisco, California, United States

  Disclosure information not submitted.
• 

  John J. Park, MD FACS FASCRS

  Clinical Professor of Surgery
  University of Illinois at Chicago
  University of Illinois College of Medicine
  Lake Forest, Illinois, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• 

  Slawomir J. Marecik, MD, FACS, FASCRS

  Associate Professor of Clinical Surgery, UIC
  Advocate Lutheran General Hospital, Park Ridge, IL
  University of Illinois at Chicago
  Park Ridge, IL, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no relevant relationships with ineligible companies.

Senior Author(s)

• KK

  Kunal Kochar, MD FACS FASCRS

  Colon and Rectal Surgeon
  Lutheran General Hospital
  Park Ridge, Illinois, United States

  Disclosure information not submitted.

Author(s)

• 

  Alberto J. Parra Vitela, MD. MS (he/him/his)

  Colorectal Fellow
  Cook County Health System
  Madison, WI, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Minimally invasive colorectal surgery is associated with a lower incidence of adhesions and small bowel obstruction (SBO) as compared to open surgery. However, the impact of hand-assisted laparoscopic (HALS) surgery has not been well studied.Methods/Interventions: Retrospective review of a prospectively maintained database of minimally invasive left colon and rectal resections conducted at a community-level hospital from April 2010 to October 2022 to allow for a minimum 12-month follow-up period. The primary outcome was the incidence of small bowel obstruction in patients undergoing pure laparoscopy, HALS, and robotic resections. Secondary outcome measures were the 30-day complication rate as measured by the Clavien-Dindo scale, median time to SBO, and length of hospital stay. A linear regression was performed to identify factors associated with length of hospital stay and logistic regression was performed to analyze the impact of various factors on the development of SBO.Results/Outcomes: A total of 1006 left colon and rectal resections were analyzed with an incidence of SBO of 4.6%. There was no difference in the incidence of SBO in pure laparoscopy, HALS and robotic resection groups (2.5%, 4.1%, and 7.3%, p=0.064) or in the median time to the development of SBO (312days, 203 days and 400 days, p=0.554). On linear regression, the only factors associated with an increase in hospital stay were age and 30-day complication rate while type of MIS approach was not significantly associated with length of hospital stay.On multivariable logistic regression, only length of hospital stay was predictive for the development of SBO (OR 1.186, p=0.008) while the type of MIS approach, malignant diagnosis, development of complication ≥CD3a, development ventral hernia, and prior surgical history were not predictive.Conclusion/

Discussion: The type of minimally invasive approach does not influence the length of hospital stay or development of SBO after left colon and rectal resections. However, the length of hospital stay after index surgery is predictive of the development of SBO."Table 1

Demographic, operative and postoperative details.
Table 2

Logistic regression of factors predicting development of SBO.
Linear regression of factors predicting hospital stay.

Linear regression of factors predicting hospital stay."