Laparoscopic adhesiolysis for recurrent small bowel obstruction: Long-term follow-up

Background: Recurrent small bowel obstruction caused by postoperative adhesions has traditionally been treated by conventional laparotomy, but laparoscopic management of acute small bowel obstruction has been reported. The aim of this study was to assess the long-term efficacy and clinical outcome o...

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Published in:Gastrointestinal endoscopy 2001-10, Vol.54 (4), p.476-479
Main Authors: Sato, Yoshiaki, Ido, Kenichi, Kumagai, Machio, Isoda, Norio, Hozumi, Masanori, Nagamine, Nobuhiko, Ono, Kazunori, Shibusawa, Hiroyuki, Togashi, Kazutomo, Sugano, Kentaro
Format: Article
Language:English
Subjects:
Abdomen
Biological and medical sciences
Feasibility Studies
Female
Follow-Up Studies
Humans
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Laparoscopy
Laparotomy
Male
Medical sciences
Middle Aged
Postoperative Complications - surgery
Recurrence
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Time Factors
Tissue Adhesions - surgery
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Summary:Background: Recurrent small bowel obstruction caused by postoperative adhesions has traditionally been treated by conventional laparotomy, but laparoscopic management of acute small bowel obstruction has been reported. The aim of this study was to assess the long-term efficacy and clinical outcome of laparoscopic adhesiolysis for recurrent small bowel obstruction. Methods: After conservative treatment, elective laparoscopic treatment was attempted in 17 patients hospitalized for recurrent small bowel obstruction after abdominal or pelvic surgery. Results: Postoperative adhesions were identified laparoscopically in all patients. Laparoscopic treatment was possible in 14 patients (82.4%). Conversion to laparotomy was required for 3 patients (17.6%) because of intestinal perforation (n = 1) or a convoluted mass of adherent bowel (n = 2). Long-term follow-up was possible in 16 patients. Two recurrences of small bowel obstructions were noted over a mean follow-up period of 61.7 months. Conclusions: Laparoscopic adhesiolysis is a safe and effective treatment for recurrent small bowel obstruction. Conversion to laparotomy should be considered in patients with dense adhesions. (Gastrointest Endosc 2001;54:476-9.)
ISSN:0016-5107
1097-6779
DOI:10.1067/mge.2001.117760