Laparoscopic Management of Acute Intestinal Obstruction

Salama, Tamer M Said

doi:10.4172/2161-1076.1000290

“…The conversion rate in our study with MASBO and a mean of 2.3 previous laparotomies was only 1.4% for the laparoscopic multi-port approach and 0% for the single port approach, results lower than those described by Okamoto et al 1 Miller et al and Borzellino et al from 6.2% to 52% 15,16 . Only Di Saverio et al reported a conversion rate of 3.5%, but they do not include MASBO patients with diffuse and dense matted adhesions like in our study [14][15][16][17][18][19] .…”

Section: Discussionmentioning

confidence: 72%

Minimal invasive surgery for multiple adhesive small bowel obstruction: Results of a comparative multicenter study

Gómez,

Cabrera-Vargas,

Pedraza

et al. 2023

CIRUE

0

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Aim of the study: Laparoscopic adhesiolysis in small bowel obstruction (SBO) is getting increasingly normal. In patients with multiple adhesive SBOs (MASBO), laparoscopic approaches might increase the risk of bowel injury due to the distended and potentially compromised small bowel. It remains a challenge to the surgeons, entails an interdisciplinary team, trying to achieve the least complications as possible. The study aimed to compare surgical outcomes of laparoscopic procedures (multi-port vs. single-port) in the management of MASBO. Patients and Methods: Comparative study of 68 patients with post-operative MASBO treated with Single-Port single incision laparoscopic surgery (SILS) and Multi-port Laparoscopic Surgery in two centers of Bogota, Colombia between January 2013 and June 2018. Results: All patients underwent laparoscopic management, 27 patients by SILS, and 41 patients by multi-port. The average surgical time in the multiport approach was 167 min versus SILS with 129 min. Laparoscopic intestinal resection was performed in 4.4% of patients, through multi-port using intracorporeal anastomosis. Mean hospital stay of 3.2 days for the SILS approach versus multi-port in 2.2 days. Conclusions: Both laparoscopic approaches, in MASBO treatment is feasible in qualified hands. Patient selection and medical judgment seem to be the most essential factors for a positive result.

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“…Two patients presented readmission due to obstructive intestinal symptoms that they subsequently resolved with medical management, which presented surgical history of sigmoidectomy for acute diverticulitis Hinchey III and IV, at the 1-year follow-up, they did not repeat the SBO episode, so they probably did not require surgical management again. Others operative complications such as post-operative bronchoaspiration, postoperative ileus, missed enterotomy, and pulmonary embolism were less to those in the multiport laparoscopic group 1,3,5,[17][18][19][20] . The main limitation of this study is that is an observational comparative study without randomization.…”

Section: Discussionmentioning

confidence: 74%

“…The conversion rate in our study with MASBO and a mean of 2.3 previous laparotomies was only 1.4% for the laparoscopic multi-port approach and 0% for the single port approach, results lower than those described by Okamoto et al 1 Miller et al and Borzellino et al from 6.2% to 52% 15,16 . Only Di Saverio et al reported a conversion rate of 3.5%, but they do not include MASBO patients with diffuse and dense matted adhesions like in our study [14][15][16][17][18][19] .…”

Section: Discussionmentioning

confidence: 98%

Manejo mínimamente invasivo para las obstrucciones debidas a múltiples adherencias del intestino delgado (OMAID): resultados de un estudio comparativo múlticentrico

Gómez¹,

Cabrera‐Vargas²,

Pedraza³

et al. 2021

CIRU

1

0

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Aim of the study: Laparoscopic adhesiolysis in small bowel obstruction (SBO) is getting increasingly normal. In patients with multiple adhesive SBOs (MASBO), laparoscopic approaches might increase the risk of bowel injury due to the distended and potentially compromised small bowel. It remains a challenge to the surgeons, entails an interdisciplinary team, trying to achieve the least complications as possible. The study aimed to compare surgical outcomes of laparoscopic procedures (multi-port vs. single-port) in the management of MASBO. Patients and Methods: Comparative study of 68 patients with post-operative MASBO treated with Single-Port single incision laparoscopic surgery (SILS) and Multi-port Laparoscopic Surgery in two centers of Bogota, Colombia between January 2013 and June 2018. Results: All patients underwent laparoscopic management, 27 patients by SILS, and 41 patients by multi-port. The average surgical time in the multiport approach was 167 min versus SILS with 129 min. Laparoscopic intestinal resection was performed in 4.4% of patients, through multi-port using intracorporeal anastomosis. Mean hospital stay of 3.2 days for the SILS approach versus multi-port in 2.2 days. Conclusions: Both laparoscopic approaches, in MASBO treatment is feasible in qualified hands. Patient selection and medical judgment seem to be the most essential factors for a positive result.

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“…The Laparoscopic approach was first used to deal with IO in 1991 by Bastug et al They performed laparoscopic band release for intestinal obstruction caused by a single adhesive band [48].…”

Section: Treatmentmentioning

confidence: 99%

Small Bowel Volvulus In Adult: A Review Of Literature

Shyam

¹

,

Shyam

²

2020

EJMED

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A Small bowel volvulus is a rare entity where the small bowel loop twists around its own mesentery. These twisting may produce a mechanical obstruction, vascular compromise, or both. In North America and Western Europe, the annual incidence of small bowel volvulus is 1.7 to 5.7 cases per 100,000, but much higher rates of 24 to 60 cases per 100,000 have been observed in Africa, Asia, the Middle East, and India. Small bowel volvulus can be classified as primary and secondary subtypes. In primary variety, there is no known cause whereas secondary variety occurs due to the presence of predisposing lesions, either congenital or acquired of which postoperative adhesion is the most common responsible factor. The most commonly accepted explanation for the initiation of primary small bowel volvulus is the abnormal bowel peristalsis generated due to the sudden overfilling of the empty bowel loop with a large portion of meal after prolong fasting. Secondary small bowel volvulus is commonly seen in the elderly population with mixed gender distribution. There are no specific clinical features or laboratory findings and a high index of suspicion is required to reach a diagnosis. Abdominal pain is the most common presenting feature of small bowel volvulus. CT scan is the investigation of choice and a whirl sign is the characteristic finding of bowel volvulus. Urgent Surgical exploration is the treatment of choice to prevent complications due to vascular compromise. Although small bowel volvulus is rare, it has a mortality rate between 9% and 35%, which can reach up to 100% if associated with bowel necrosis.

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Laparoscopic Management of Acute Intestinal Obstruction

Cited by 3 publications

References 30 publications

Minimal invasive surgery for multiple adhesive small bowel obstruction: Results of a comparative multicenter study

Minimal invasive surgery for multiple adhesive small bowel obstruction: Results of a comparative multicenter study

Manejo mínimamente invasivo para las obstrucciones debidas a múltiples adherencias del intestino delgado (OMAID): resultados de un estudio comparativo múlticentrico

Small Bowel Volvulus In Adult: A Review Of Literature

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