Laparoscopic adhesiolysis for acute small bowel obstruction: systematic review and pooled analysis

Wiggins, Tom; Markar, Sheraz R.; Harris, Amy

doi:10.1007/s00464-015-4114-0

Cited by 43 publications

(33 citation statements)

References 26 publications

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“…29 However, a systematic review showed that LS for SBO did not increase the risk of bowel injury compared with OS (95% CI 0.24~2.46; p=0.65). 30 Although there was only one case (3.2%) of bowel perforation in the LS group, the incidence of bowel perforation in the present study was lower than those of previous studies. In LS, we insert the first trocar using Hasson' s technique and then introduce the other trocars under direct camera visual guidance.…”

Section: Discussioncontrasting

confidence: 81%

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

Kim

Park

Kim

et al. 2018

J Minim Invasive Surg

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Purpose: Laparoscopic adhesiolysis is increasingly used to treat patients with small bowel obstruction (SBO), however, its safety of laparoscopic surgery(LS) with bowel resection in SBO is unclear. The purpose of the present study was to compare the perioperative outcomes of LS with those of open surgery (OS) for SBO and to evaluate the risk factors of 30-day postoperative morbidity and recurrence. Methods:We retrospectively reviewed medical records of patients who had been diagnosed with SBO and underwent surgery at four Hallym-University-affiliated hospitals between January 2013 and December 2016. The rates of 30-day postoperative complications and recurrence were compared between groups using univariate and multivariate analysis. Propensity score matching was performed to compare the outcome.Results: A total of 117 patients with SBO were included in the present study, of which 86 underwent OS and 31 underwent LS. Time to water intake, time to soft diet, and postoperative hospital stay were significantly shorter in the LS group (p=0.002, 0.003, and 0.027, respectively). The complication (p=0.249) and recurrence rate (p=0.679) were similar between the two group. Propensity score matching analysis demonstrated that laparoscopic surgery showed quicker recovery and similar complication and recurrence rate. In multivariate analysis, LS was not associated with either complications (p=0.806) or recurrence (p=0.956). Conclusion:LS is associated with several perioperative advantages for the treatment of SBO without affecting the risk of 30-day postoperative complications or recurrence. Therefore LS can be a safe and feasible option for treating SBO.

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Section: Discussioncontrasting

confidence: 81%

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

Kim

Park

Kim

et al. 2018

J Minim Invasive Surg

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“…However, the operative time and the incidence of iatrogenic enterotomy were not reduced. Other previously published systematic reviews [26], [27] also showed the benefit of laparoscopic surgery for SBO. They demonstrated that laparoscopic adhesiolysis is safe and feasible in patients with SBO.…”

Section: Discussionmentioning

confidence: 72%

“…Several studies have reported that the laparoscopic approach did not increase the risk of iatrogenic bowel injury in comparison to open surgery [14], [27], [32]. Recent reports have shown the rate of conversion to be 10–39% [24], [33], [34], [35], [36].…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of laparoscopic surgery for small bowel obstruction

Otani

Ishihara

Nozawa

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundOpen laparotomy is widely accepted as the standard surgical treatment for small bowel obstruction (SBO). However, laparoscopic surgery has recently become a treatment option. There is no consensus on the appropriate settings for the laparoscopic treatment of SBO. The purpose of this study is to evaluate the outcomes of laparoscopic surgery for SBO.Patients and methodsFrom January 2012 to May 2016, 48 consecutive patients underwent surgical treatment for SBO in our department. We retrospectively reviewed these cases and compared the features and the outcomes between laparoscopic and open surgery.ResultsThirty-four and 14 patients underwent open surgery and laparoscopic surgery, respectively. Four of the laparoscopic cases (28.6%) were converted to open surgery. Laparoscopic surgery tended to be associated with a shorter operative time than open surgery (p = 0.066). The first postoperative oral intake was significantly earlier in patients who underwent laparoscopic surgery (p = 0.044). The duration of hospitalization after surgery and the rates of postoperative complications did not differ to a statistically significant extent. Laparoscopic treatment was accomplished in 7 out of 8 cases (87.5%) with SBO due to band occlusion.ConclusionLaparoscopic surgery for SBO is less invasive than open surgery and is equally feasible in selected patients. SBO due to band occlusion may be a preferable indication for laparoscopic surgery. In order to confirm the safety of laparoscopic treatment, and to clarify the appropriate settings for laparoscopic surgery for SBO, it will be necessary to perform further studies in a larger population and with a long follow-up period.

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“…Pooled analyses of non-randomized series suggest significant reductions in mortality, morbidity, wound infections, and length of hospital stay by using laparoscopic approach instead of open surgery. [7][8][9][10] It is acknowledged that these series have high risk of bias owing to obvious selection of less severe cases to laparoscopic approach. 10,11 Although laparoscopic approach is used more frequently than before, 12,13 it has not gained widespread acceptance.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 The lack of widespread adoption can be appointed to three major reasons: laparoscopic adhesiolysis is technically demanding, 3 it has been associated with higher risk of iatrogenic bowel injury, 12 and, to our knowledge, there is no randomised evidence of benefit and safety. 8,10,11,13 Because of controversy regarding the safety and benefits of laparoscopic adhesiolysis over open approach for small bowel obstruction, we conducted LAparoscopic versuS open adhesiolysis for adhesive Small bowel Obstruction (LASSO) trial. The main hypothesis was that laparoscopic adhesiolysis is feasible treatment of adhesive small bowel obstruction, and it shortens the length of hospital stay without increasing morbidity.…”

Section: Introductionmentioning

confidence: 99%