{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:56:24Z","timestamp":1789185384347,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer is the third most common malignancy in the U.S., frequently managed with surgical resection. Adhesion-related complications, specifically small bowel obstruction (SBO), are frequent postoperative issues. This study examines whether minimally invasive surgery (MIS) reduces the risk of adhesive SBO compared to open surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The PubMed, EMBASE\/MEDLINE, and Cochrane databases were queried to identify studies comparing open vs MIS colorectal cancer resection. The primary endpoints were the incidence of adhesive SBO, SBO requiring surgery, parastomal hernia, and incisional hernia rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies met inclusion criteria, comprising six randomized controlled studies (RCTs) and four non-RCTs, with a total of 23\u00a0032 patients\u201436.5% in the MIS group and 63.5% in the open group. Pooled analysis revealed a significantly lower incidence of adhesive SBO (RR: 0.58; CI: 0.45-0.75;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001), SBO requiring surgery (RR: 0.69; CI: 0.49-0.96;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03), and infection rate (RR: 0.67; CI: 0.55-0.82;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) in the MIS group. No difference was seen in SBO requiring admission, incisional hernia (IH), IH requiring surgery, or length of hospital stay (LOS). The open group had a lower incidence of parastomal hernias (RR: 2.06; CI: 1.31-3.25;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002). Sensitivity analysis by using leave-one-out analysis also showed a significant reduction of adhesive SBO in the MIS group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study found reduced incidence of SBO, the need for SBO surgery, and infection rate with MIS surgery in colorectal cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251407346","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:43:02Z","timestamp":1765294982000},"page":"1740-1751","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Minimally Invasive Surgery on the Incidence of Adhesive Small Bowel Obstruction and Related Complications Following Colorectal Cancer Resections: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5129-3964","authenticated-orcid":false,"given":"Valberto","family":"Sanha","sequence":"first","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josip","family":"Plascevic","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Aberdeen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanio","family":"Livramento Junior Antunes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Federal University of Health Science of Porto Alegre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-4744","authenticated-orcid":false,"given":"Chase J.","family":"Wehrle","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumaran","family":"Shanmugarajah","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-9959","authenticated-orcid":false,"given":"Dante L. S.","family":"Souza","sequence":"additional","affiliation":[{"name":"TriHealth Good Samaritan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Maklad","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Osman","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Fujiki","sequence":"additional","affiliation":[{"name":"Cleveland 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