[Laparoscopic treatment of mechanical small bowel obstruction]. 2011

Brahim Ghariani, and Hichem Houissa, and Farouk Sebai
Hôpital la Rabta, Service de Chirurgie B, Tunis, Tunisie.

BACKGROUND A history of abdominal surgery have long been considered a contraindication to laparoscopy. There was a reluctance to advocate the use of laparoscopy in mechanical bowel obstruction due to technical difficulties related to a distended small intestine, and a small work space. OBJECTIVE To report the results of laparoscopic treatment of small bowel mechanical obstruction and to study the factors for conversion to laparotomy. METHODS Our study is retrospective, having compiled 32 patients between January 2001 and December 2009. The average age was 35 years (20-54). There were 17 men and 15 women. History of laparotomies were noted in 27 patients. Were excluded from this study patients with strangulated hernia or eventration. An analysis was conducted to determine the conversion factors to laparotomy RESULTS The flanges or postoperative adhesions were responsible for 27 of the 32 intestinal obstructions (84%). In 24 cases there was a single flange or localized adhesions treated by simple section successfully in 18 patients (56% of cases). A conversion was performed in 14 cases (44%). the median time to recovery of intestinal transit was shorter after laparoscopic surgery completely after conversion (1.5 vs. 2.5 days, p = 0.004). Similarly, the median length of postoperative stay was shorter in the absence of conversion (2.4 vs 7, p <0.001). Statistical analysis identified four factors related to conversion, which are: the presence of peritoneal signs, the number of brackets> 1, and the need for a bowel resection. CONCLUSIONS Laparoscopy is an option for the treatment of mechanical bowel obstruction when performed in selected patients. His best indication could be the occlusion of single flange. This alternative to laparotomy could reduce adhesion formation and potentially reduce future episodes of obstruction.

UI MeSH Term Description Entries
D007415 Intestinal Obstruction Any impairment, arrest, or reversal of the normal flow of INTESTINAL CONTENTS toward the ANAL CANAL. Intestinal Obstructions,Obstruction, Intestinal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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