{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:09:18Z","timestamp":1789088958789,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postoperative small bowel obstruction (SBO) is a major complication following colorectal cancer surgery, yet evidence\u2010based prevention strategies remain unclear. We aimed to clarify site\u2010specific risk factors for SBO and evaluate the effectiveness of laparoscopic surgery and adhesion prevention materials (APMs) in preventing SBO after colorectal cancer surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analyzed 5458 patients who underwent colorectal cancer surgery at 32 Japanese institutions between 2012 and 2014. The primary endpoint was the 5\u2010year risk of SBO. We evaluated the effects of laparoscopic surgery, APM use, and stoma creation on SBO risk. Clinical variables included demographics, tumor site, operative approach, operative details, and postoperative complications. Hospital\u2010level clustering was addressed using mixed\u2010effects logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall SBO incidence was 5.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009283). Rectal cancer had the highest risk, whereas all colonic sites except the descending colon showed significantly lower odds. Laparoscopic surgery was associated with a 42% reduction in odds (OR 0.58; 95% CI 0.45\u20130.74;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with significant reductions in ascending (NNT\u2009=\u200922.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and sigmoid colon surgery (NNT\u2009=\u200930.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). APMs showed no protective effect (OR 1.01; 95% CI 0.78\u20131.32;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.94). Stoma creation significantly increased SBO risk (OR 1.84; 95% CI 1.35\u20132.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Secondary analysis identified reoperation and postoperative ileus as additional independent risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Laparoscopic surgery was associated with reduced long\u2010term SBO risk, with significant benefits in ascending and sigmoid colon surgery. APMs showed no measurable benefit. Stoma creation increased SBO risk, with no observed difference between ileostomy and colostomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70280","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:41:06Z","timestamp":1789087266000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Surgery Is Associated With Reduced Small Bowel Obstruction Risk After Colorectal Cancer Surgery: A Nationwide Cohort Study of 5458 Patients"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1436-7482","authenticated-orcid":false,"given":"Takeshi","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Surgery Kurume University School of Medicine  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3628-4493","authenticated-orcid":false,"given":"Ken","family":"Eto","sequence":"additional","affiliation":[{"name":"Department of Surgery The Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozo","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Division of Lower GI, Department of Gastroenterological Surgery Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Yukawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiichi","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Coloproctological Surgery Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8601-0442","authenticated-orcid":false,"given":"Rai","family":"Shimoyama","sequence":"additional","affiliation":[{"name":"Department of General Surgery Saitama Memorial Hospital  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Fukazawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Iwata City Hospital  Iwata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Kumamoto","sequence":"additional","affiliation":[{"name":"Department of Genome Medical Science and Medical Genetics, Faculty of Medicine Kagawa University  Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Surgery Ogaki Municipal Hospital  Ogaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Komono","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Fukuoka University Faculty of Medicine  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6468-9375","authenticated-orcid":false,"given":"Akihisa","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2627-2859","authenticated-orcid":false,"given":"Ryo","family":"Ohta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromichi","family":"Sonoda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3869-8216","authenticated-orcid":false,"given":"Koichi","family":"Okuya","sequence":"additional","affiliation":[{"name":"Department of Surgery JR Sapporo Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Dokkyo Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuki","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Surgery 1, School of Medicine University of Occupational and Environmental Health  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"First Department of Surgery Yamanashi University  Kofu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"5","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"S362","DOI":"10.1097\/TA.0b013e31827019de","article-title":"Evaluation and Management of Small\u2010Bowel Obstruction: An Eastern Association for the Surgery of Trauma Practice Management Guideline","volume":"73","author":"Maung A. 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