Laparoscopic Versus Open Adhesiolysis for Small Bowel Obstruction: A Single-Center Retrospective Case-Control Study

Lin, Hao; Li, Jiante; Xie, Zhiyuan; Zhang, Wentao; Liu, Xiaopeng

doi:10.1097/sle.0000000000000259

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Turning to the length of hospital stay, in agreement with several studies,[ 8 , 9 , 21 ] laparoscopic adhesiolysis is associated with a dramatic decrease in hospital stay in comparison to open adhesiolysis. Lin et al .…”

Section: Discussionsupporting

confidence: 86%

Laparoscopic adhesiolysis versus open adhesiolysis in acute adhesive small bowel obstruction

Elkomos

Fahmy

Kamel

2023

Journal of Minimal Access Surgery

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Introduction: Exploratory laparotomy is still the standard therapy for patients who need surgical intervention for adhesive small bowel obstruction (SBO). However, the use of laparoscopy in the management of adhesive SBO is still controversial. We aimed to detect the short-term outcomes between open and laparoscopic adhesiolysis for SBO. Patients and Methods: This is a retrospective study of patients with adhesive SBO who underwent either laparoscopic or open surgery from June 2019 to July 2022 at Ain Shams University Hospitals. Intraoperative and early post-operative outcomes were compared in the two groups. Results: A total of 89 patients with adhesive SBO were included in our study. Fifty-one cases underwent open adhesiolysis and 38 cases underwent laparoscopic adhesiolysis. Laparoscopic adhesiolysis is associated with a remarkable decrease in the operative time (71 min vs. 107 min, P = 0.001) and blood loss (50 ml vs. 120 ml, P = 0.001) in comparison to open adhesiolysis. In addition to that, those who underwent adhesiolysis by laparoscopy had a short hospital stay (2.4 days vs. 3.8 days, P = 0.001), early recovery (time to pass flatus 1.3 days vs. 2.8 days) and less post-operative complications (surgical site infection [SSI] 2.6% vs. 19.6%, P = 0.001). Moreover, open adhesiolysis is associated with a higher rate of early post-operative mortality. In addition to that, the incidence of iatrogenic injury was higher in the open group. Conclusion: Laparoscopic adhesiolysis is a safe and feasible approach for the management of SBO and has better short-term outcomes, especially if done by skilled surgeons in advanced laparoscopic techniques.

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Section: Discussionsupporting

confidence: 86%

Laparoscopic adhesiolysis versus open adhesiolysis in acute adhesive small bowel obstruction

Elkomos

Fahmy

Kamel

2023

Journal of Minimal Access Surgery

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“…The studies span an 11‐year period from 2010 to 2021. The studies included 54 retrospective cohort studies [17–70], eight prospective cohort studies [4, 71–77], seven RCTs [78–84], and four retrospective case–control studies [85–88]. 45 studies were single centre, 20 utilised databases and 8 were multicentre.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of participant descriptors reported in studies of adhesive small bowel obstruction

Rashid,

Kumar,

Lee

2024

Colorectal Disease

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AimReporting of participant descriptors in studies of adhesive small bowel obstruction (ASBO) can help identify characteristics associated with favourable outcomes and allow comparison with other studies and real‐world clinical populations. The aim was to identify the pattern of participant descriptors reported in studies assessing interventions for ASBO.MethodThis systematic review was registered with PROSPERO (CRD42021281031) and reported in line with the PRISMA checklist. Systematic searches of Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) were undertaken to identify studies assessing operative and non‐operative interventions for adults with ASBO. Studies were dual screened for inclusion. Descriptors were categorised into conceptual domains by the research team.ResultsSearches identified 2648 studies, of which 73 were included. A total of 156 unique descriptors were identified. On average, studies reported 12 descriptors. The most frequently reported descriptors were sex, age, SBO aetiology, history of abdominal surgery, BMI and ASA classification. The highest number of descriptors in a single study was 34, compared to the lowest number of descriptors which was one. Pathway factors were the least frequently described domain. Overall, 37 descriptors were reported in just one study.ConclusionThere is a lack of consistency in participant descriptors reported in studies of SBO. Furthermore, a significant proportion of the descriptors were used infrequently. This makes it challenging to assess whether study participants are representative of the wider population. Further work is required to develop a Core Descriptor Set to standardise the reporting of patient characteristics and reduce heterogeneity between studies.

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“…In the series presented by Halabi et al, the average length of stay for all patients undergoing surgery for gallstone ileus was 12 days; this is longer than the reported laparoscopic and open postoperative stays noted with adhesive bowel obstructions as measured by Lin et al of 6.4 ± 2.1 and 7.2 ± 2.9, respectively [ 1 , 8 ]. A review of laparoscopic and open cases for gallstone ileus by Moberg and Montgomery showed a shorter, but not statistically significant, length of stay with laparoscopic procedures, 7 days for laparoscopic versus 10 days for open [ 8 , 9 ]. When cholecystectomy, fistula closure, and/or bowel resection are undertaken in addition to the enterolithotomy, the operative time and postoperative length of stay for patients were significantly longer [ 2 ].…”

Section: Discussionmentioning

confidence: 97%

Technical Approach to Laparoscopic Examination of the Small Bowel in Gallstone Ileus

Assali

Mourany

Jones

et al. 2020

Case Reports in Surgery

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Background. Gallstone ileus is an infrequent cause of small bowel obstructions (SBO), accounting for only 0.1-5% of SBOs and 25% of nonstrangulating causes of SBO in the elderly population. There is scant literature available regarding the use of laparoscopy to treat gallstone ileus. Currently, much of the literature available is limited to case reports only. Methods. A complete laparoscopic approach was utilized to manage a 65-year-old woman with morbid obesity who presented with gallstone ileus. With regard to our technical approach, we describe the technical approach that facilitates safe laparoscopic examination of the entire small bowel and can be applied to other acute care surgery cases involving small bowel pathology. Results. The patient’s postoperative course was complicated by new-onset atrial fibrillation which was treated medically with good response. She was safely discharged on postoperative day 2. Conclusion. Laparoscopy is a feasible option for the management of gallstone ileus and can lead to decreased morbidity compared to laparotomy. The technique described allows for laparoscopic examination of the entire small bowel.

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Laparoscopic Versus Open Adhesiolysis for Small Bowel Obstruction: A Single-Center Retrospective Case-Control Study

Abstract: The laparoscopic approach for SBO is feasible because of its fewer complications and hospital stay.

Cited by 13 publications

References 24 publications

Laparoscopic adhesiolysis versus open adhesiolysis in acute adhesive small bowel obstruction

Laparoscopic adhesiolysis versus open adhesiolysis in acute adhesive small bowel obstruction

A systematic review of participant descriptors reported in studies of adhesive small bowel obstruction

Technical Approach to Laparoscopic Examination of the Small Bowel in Gallstone Ileus

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