Laparoscopic vs open surgery for patients with strangulated small bowel obstruction.
Asian J Endosc Surg
; 13(4): 481-488, 2020 Oct.
Article
em En
| MEDLINE
| ID: mdl-31801178
ABSTRACT
BACKGROUND:
Recent reports revealed that laparoscopic adhesiolysis is a feasible procedure for patients with adhesive small bowel obstruction (SBO). However, the feasibility of laparoscopic surgery for strangulated SBO has not been investigated in detail.METHODS:
Ninety-six patients who underwent surgery for strangulated SBO between April 2008 and September 2019 were included. Of these, 49 patients were intended to undergo laparoscopic surgery, while the other 47 underwent open surgery from the first. Comparisons were made between the patients who underwent laparoscopic and open surgery in the patients with intestinal resection and without resection, respectively.RESULTS:
In the resection group, eight patients (50.0%) who underwent laparoscopic surgery required conversion to open surgery. Perioperative outcomes were not statistically different between laparoscopic and open surgery except for postoperative use of continuous infusion of an analgesic agent or epidural anesthesia (P = .008). In the non-resection group, five patients (15.1%) who underwent laparoscopic surgery required conversion. Time from surgery to ingestion (P = .025) and postoperative use of continuous infusion of an analgesic agent or epidural anesthesia (P < .001) were significantly favorable in the laparoscopic group. In the patients who underwent laparoscopic surgery, white blood cell count was >12 000/µL (P = .024, odds ratio = 7.569) and intestinal resection (P = .026, odds ratio = 5.19) were found by logistic regression analysis to be independent risk factors for conversion to open.CONCLUSIONS:
Laparoscopic surgery yields superior outcomes in patients without a requirement of intestinal resection. Laparoscopic surgery was considered as a first-choice strategy in selected patients with strangulated SBO.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
/
Obstrução Intestinal
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Asian J Endosc Surg
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Japão