Minimally Invasive Management for Acute Small Intestine Obstruction: An Outcome Analysis
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 3
Abstract
Background: As minimally invasive surgery gains ground, it is entering realms previously considered to be relative contraindications for laparoscopy. We reviewed our experience with the laparoscopic approach to the management of small bowel obstruction (SBO). Methods: From 2010- 2014, 65 patients underwent laparoscopic treatment for SBO. The operating surgeon attempted to identify a transitional point between distended and collapsed bowel and then address the obstruction at that point. Results: Postoperative adhesions were the cause of the obstruction in 44 patients. Tumor was identified in five cases, hernia in four, bezoar in three, intussusception in three, acute appendicitis and pseudoobstruction in two cases each, and terminal ileitis in one case. The diagnostic accuracy of laparoscopy was 96.9%. Thirty-four patients (52%) were treated by laparoscopy alone. Thirteen patients (20%) required a small target incision for segmental resection. Eighteen operations were converted to formal laparotomy. The mean laparoscopy time was 40 min (range, 25–160). Patients resumed oral intake in 1–3 days. The complication rate was 6.4%. There were two deaths, but none related to laparoscopy. The mean hospital stay was 4.2 days. Conclusions: Laparoscopy is a useful minimally invasive technique for the management of acute SBO. It is an excellent diagnostic tool and, in most cases, a therapeutic surgical approach in patients with SBO. However, a significant number of patients will require conversion.
Authors and Affiliations
Pawan Bansal, Sanjay Hada, Vinita Bansal, Ankur Jhanwar
Keywords
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- EP ID EP547811
- DOI 10.21276/ijmrp.2017.3.3.025
- Views 74
- Downloads 0
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