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.
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