Study of Laparoscopic Adhesiolysis in Post Operative Adhesive Intestinal Obstruction
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2018, Vol 3, Issue 1
Abstract
Introduction: Postoperative adhesions are a common occurrence and may cause small bowel obstruction requiring a repeat surgery. Adhesive obstruction if not managed properly it may cause small bowel ischemia and potentially lethal complications. Urgent imaging including CT or MRI may diagnose the condition more accurately than conventional X-ray and Ultrasound. Laparoscopic adhesiolysis (if feasible) is associated with less morbidity and early mobilization. In some cases laparoscopic surgeries are needed to be converted to open procedure in the interest of the patient and should in no way be considered as failure. Material and Methods: We conducted this study prospective study of 40 patients admitted to department of surgery for post operative adhesive intestinal obstruction. Demographic data, history, clinical and intraoperative findings, investigations and complications during hospital stay and during follow up visits were recorded. After the conservative management all patients were posted for laparoscopic adhesiolysis. Perioperatively and postoperatively patients were managed according to standard protocol. Later patients were discharged and followed up at 15 days, 1 month, 3 months and 6 months. None of the patients presented with recurrence. The data was analyzed using SPSS16.0 version software. Results: This was a prospective study comprising of 40 patients of post-operative adhesive intestinal obstruction carried out in a tertiary care institute. The most common symptom in the studied cases was found to be abdominal pain (100%) followed by vomiting (60%), not passed stool (45%) and abdominal distension (37.5%). In majority of patients emergency surgeries were done in majority of patients (67.5%) whereas elective surgeries were done in 9 (22.5%) patients. The common indications for previous surgeries were perforation peritonitis (40%), acute appendicitis (15%) and obstetrics and gynecological surgeries (15%). Failed laparoscopic surgeries were found to be distinctively associated with wound infections (33.33%). Conclusion: Laparoscopy adhesiolysis effective and useful mode of treatment in patients with Postoperative adhesive intestinal obstruction following laparoscopic as well as open surgeries.
Authors and Affiliations
Arti Mitra, Dhara Pandya, Unmed Chandak
Keywords
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