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To determine whether the need for adhesiolysis during completionproctectomy and pouch creation is influenced by the approach and the hospital (referring or academic) of the initial colectomy.All patients that underwent a completionproctectomy with ileo pouch anal anastomosis (IPAA) between 1999 and 2009 were included. Case files were retrospectively reviewed.Ninety-one patients underwent a completionproctectomy with IPAA, of which 30 underwent a laparoscopic and 61 underwent an open emergency colectomy. Twenty-five out of 30 patients had a laparoscopic colectomy in our academic hospital, 5 out of 30 in a referring hospital. significantly more adhesiolysis was performed after open compared to laparoscopic colectomy (75% vs 20%, P < 0.001) and in patients that underwent acute colectomy in a referring hospital compared to the academic hospital (72.1% vs 42.6%, P = 0.005). Overall morbidity, hospital stay and rate of incisional hernia correction during completionproctectomy were not significantly different between the open/laparoscopic and referred/academic hospital groups. A trend showed towards a longer median operating time of the completionproctectomy and pouch for patients that were referred (resp. 151 vs 168 min, P = 0.06).Laparoscopic emergency colectomy is associated with less adhesions that require lysis during the subsequent completionproctectomy.