Laparoscopic Resection May Improve Outcomes in Acute Colonic Obstruction, suggests study

A new study published in the journal of BMC Surgery showed that in a group of chosen patients with sudden blockage in the colon, undergoing emergency laparoscopic surgery was linked to decreased postoperative complications, shorter hospitalization periods, and less requirement for strong pain relief after surgery.

Although laparoscopy is widely recognized for its advantages in planned colorectal surgery, its utilization in emergency situations is still constrained. This international multicenter study retrospectively examines the outcomes of laparoscopic and open colonic resection in individuals experiencing acute benign or malignant colonic blockages. The presence of intraperitoneal air on imaging was a reason for exclusion.

The main goals of the study were to evaluate the Comprehensive Complication Index (CCI) and the duration of hospitalization. Additional objectives encompassed assessing postoperative pain control, need for further surgery, mortality rates at 30 and 90 days, achievement of R0 resection and lymph node retrieval as appropriate, intraoperative blood loss, quality of anastomosis, and total operative duration.

Out of a total of 144 patients, 73 met the criteria for eligibility. Among these, 43 patients (58.9%) had open resections, while 30 patients (41.1%) underwent laparoscopic procedures.

The instances of obstructions were evenly split between the right and left colon. The patients in the open surgery group were of an advanced age when compared to those in the laparoscopic group (77.1 versus 61.7 years, statistically significant at p < 0.001).

Complications falling within the Clavien-Dindo II-V category were more prevalent in the open surgery group (69.8% versus 33.3%, p = 0.002), and the Comprehensive Complication Index (CCI) was higher in this group as well (27.1 versus 7.9, p < 0.001).

The length of hospital stay (LOS) was notably lengthier following open surgery compared to laparoscopic surgery (14 (IQR 8–19) days versus 6 (IQR 5–9) days, p < 0.001).

Postoperative pain was addressed by patient-controlled opioids and/or oral analgesics in 86.7% of cases after laparoscopic surgery, while 76.7% of patients received an epidural following open surgery (p < 0.001). The remaining secondary outcomes did not display significant differences between the two groups.

Overall, emergency laparoscopic colon surgery led to lower complication rates, shorter hospital stays, and less need for strong painkillers after the operation. Yet, it is important to interpret these results carefully, as there were significant variations in the patients' initial conditions and the surgeons' expertise among the groups. 

Source:

de Groof, J., Marchesi, S., Pearce, E., Rockall, T., Vedin, T., & Agger, E. (2026). Laparoscopic versus open emergency colonic resection for obstruction: a multicentre retrospective cohort study. BMC Surgery, 26(1). https://doi.org/10.1186/s12893-026-04220-4