Laparoscopic Versus Open Adhesiolysis in Patients with Bowel Obstruction
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 70, Issue 8
Abstract
<strong>Background: </strong>Adhesions are bands of scar tissue that form between organs. In the abdomen, they form after an abdominal surgery or after a bout of intra-abdominal infection (i.e., pelvic inflammatory disease, diverticulitis). More than 95% of patients who undergo abdominal surgery develop adhesions; these are nearly inevitably part of the body’s healing process. Though most adhesions are asymptomatic, some can cause bowel obstructions, infertility, and chronic pain. <strong>Objectives:</strong> Concerning whether patients with chronic pelvic pain benefit from laparoscopic adhesiolysis or whether any appearing advantage is a placebo effect. <strong>Materials and methods: </strong>This review was conducted using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1990, through October 31, 2017. <strong>Results:</strong> The spectrum of treatments for a small-bowel obstruction ranges from conservative management with bowel rest to surgical intervention, sometimes involving bowel resection. The caveat with regard to surgical treatment is that while surgery may be required to release symptomatic adhesions, postoperative reformation of these adhesions is common. Debate continues as to whether laparoscopic adhesiolysis yields added benefit in terms of decreasing postoperative adhesion reformation; however, promising results have been obtained with Open approach. <strong>Conclusion: </strong>Laparotomy with open adhesiolysis has been the treatment of choice for acute complete bowel obstructions. Patients who have partial obstructions, with some enteric contents traversing the obstruction, might similarly require surgery if nonoperative measures fail.
Authors and Affiliations
Eman Helal
Keywords
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