None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .
Long-Term Morbidity and Oncologic Outcomes of Laparoscopic-Assisted Anterior Resection for Upper Rectal Cancer: Ten-Year Results of a Prospective, Randomized Trial
PURPOSE : We have previously reported the five-year results of a r and omized trial comparing laparoscopic and open resection for cancer of the upper rectum and rectosigmoid junction . The aim of this follow-up study is to report on the long-term morbidity and ten-year oncologic outcomes among the subgroup of patients with upper rectal cancer . METHODS : From September 1993 to October 2002 , 153 patients with upper rectal cancer were r and omly assigned to receive either laparoscopic-assisted ( n = 76 ) or open ( n = 77 ) anterior resection .  Patients were last followed up in December 2007 . Long-term morbidity , survival , and disease-free interval were prospect ively recorded . Data were analyzed by intention-to-treat principle . RESULTS : The demographic data of the two groups were comparable . More patients in the open group developed adhesion-related bowel obstruction requiring hospitalization ( P = 0.001 ) and intervention . The overall long-term morbidity rate was also significantly higher in the open group ( P = 0.012 ) . After curative resection , the probabilities of cancer-specific survival at ten years of the laparoscopic-assisted and open groups were 83.5 percent and 78.0 percent , respectively ( P = 0.595 ) , and their probabilities of being disease-free at ten years were 82.9 percent and 80.4 percent , respectively ( P = 0.698 ) . CONCLUSION : Laparoscopic-assisted anterior resection for upper rectal cancer is associated with fewer long-term complications and similar ten-year oncologic outcomes when compared with open surgery
None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .