Results of a Laparoscopic Approach for the Treatment of Acute Small Bowel Obstruction due to Adhesions and Internal Hernias

Poves, Ignasi; Sebastian‐Valverde, Enric; Companyó, Sònia Puig; Dorcaratto, Dimitri; Membrilla, Estela; Pons, María J.; Grande, Luís

doi:10.1016/j.cireng.2013.05.008

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…[6][7][8][9] In addition, recent studies indicate the utility of laparoscopic evaluation in the diagnosis of acute small bowel obstruction, including SSBO, 10 and the utility of laparoscopic surgery as a treatment approach has also been recognized. 2,3 Accordingly, in the present study, compared with the patients who underwent laparotomy, including those who were converted from laparoscopy, those who underwent laparoscopic surgery alone for SSBO exhibited several benefits such as shorter operation time, reduced bleeding, shorter postoperative hospital stay, shorter time from surgery to ingestion, and reduced incidence of complications. These results clearly demonstrate that complete laparoscopy provides significantly better surgical outcomes compared with laparotomy in patients with SSBO.…”

Section: Analysis Of Risk Factors For Laparotomymentioning

confidence: 73%

“…18 Studies suggest that surgery performed by proficient surgeons can improve outcomes in patients with ASBO. 2,19 Patients with SSBO tend to be in a worse general condition than those with ASBO, and it may be necessary to determine whether the patient should be converted to laparotomy and whether bowel resection should be performed. Therefore, the proficiency of surgeons is of utmost importance in patients with SSBO.…”

Section: Analysis Of Risk Factors For Laparotomymentioning

confidence: 99%

“…SSBO, which can result from various conditions, such as internal hernia and volvulus of the small bowel, often develops suddenly, and the diagnosis in routine medical practice is challenging in most cases. Although several recent studies reported the use of laparoscopic surgery for the diagnosis and treatment of ASBO, 2,3 most studies on SSBO include a small number of cases and there is no consensus on indications of laparoscopic surgery for specific SSBO cases. We therefore performed a retrospective study to compare outcomes between patients with SSBO who underwent complete laparoscopy and those who required laparotomy.…”

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confidence: 99%

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Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Hayakawa

Uehara

et al. 2021

Asian J Endoscop Surgery

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Introduction: Despite increasing reports of laparoscopy for strangulated small bowel obstruction (SSBO), there is no consensus on outcomes in patients with SSBO. We evaluated the safety and utility of laparoscopy for SSBO and investigated the preoperative risk factors for laparotomy. Methods: This retrospective study included 107 patients who underwent emergency surgery for SSBO over a period of 6 years. Patients' characteristics and surgical parameters were compared between 27 patients undergoing laparoscopy alone (group L) and 80 patients undergoing laparotomy (group O, including conversion). Univariate and multivariate analyses were performed to determine risk factors for laparotomy.Results: Compared with group L, group O had significantly shorter operation time (59 vs 115 minutes, P < .001), shorter postoperative hospital stay (6 vs 10 days, P < .001), and fewer complications (3 vs 40 cases, P < .001). Age ≥ 68 years (odds ratio [OR] 3.970, P = .021), blood urea nitrogen (BUN) ≥ 14.6 mg/dL (OR 4.360, P = .012), and lactate ≥2.80 mmol/L (OR 12.90, P = .023) were independent risk factors for laparotomy. Conclusion: Prognosis was better in patients with SSBO undergoing complete laparoscopy than in patients undergoing laparotomy; however, age, BUN, and lactate were independent preoperative risk factors for laparotomy.

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Section: Analysis Of Risk Factors For Laparotomymentioning

confidence: 73%

Section: Analysis Of Risk Factors For Laparotomymentioning

confidence: 99%

mentioning

confidence: 99%

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Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Hayakawa

Uehara

et al. 2021

Asian J Endoscop Surgery

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“…On the other hand the laparoscopic approache was extensively studied for small bowel obstruction [1,9,10] and allow a good evaluation for the "need for resection" [11].…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Laparoscopic Resection for Strangulated Umbilical Hernia

Moldovanu¹

2013

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Laparoscopic small bowel resection is a general accepted technique for small bowel tumors and diverticulum. However, the laparoscopic approach for intestinal resection for strangulated hernias is still controversial. This video presents the case of a 49 years old woman admitted for strangulated umbilical hernia. The patient was diagnosed with morbid obesity with a BMI of 51.3 kg/m 2. A laparoscopic approach was performed; the exploration confirmed the strangulated umbilical hernia containing small bowel. Kelotomy was necessary to reduce the small bowel. Given the ischemic injuries of the herniated small bowel segment, the resection with side-to-side stapled anastomosis was then performed. The hernia sac was also resected. The parietal defect was then closed by conventional non absorbable running suture. The postoperative course was uneventful and the patient was discharged in the 4 th postoperative day. CONCLUSION: Even the laparoscopic small bowel resection for strangulated hernia is controversial the technique is feasible and safe in obese patients and could avoid operative site infection.

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“…However, in the only randomized controlled trial published, no differences were observed in terms of morbidity and mortality(28). In addition, there is controversy about the risk of intestinal injury (23,25,28) and the morbidity associated with conversion (16,22,29,30) in patients undergoing the laparoscopic approach, which could limit its use. Therefore, there is still a long way to go to determine the true role of laparoscopy in ASBO surgery and to de ne which patients can bene t from the laparoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

Conversion Reduces the Success of Laparoscopic Approach for Adhesive Small Bowel Obstruction. A Propensity-Score Matching Analysis

Sebastian‐Valverde¹,

Téllez²,

Burdı́o³

et al. 2021

Preprint

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Background. Although the use of the laparoscopic approach has increased in recent years, the open approach remains the most widely used for surgical treatment of adhesive small bowel obstruction (ASBO). Moreover, there is no consensus in international guidelines on the role and the usefulness of the laparoscopic approach in ASBO. The aims of this study were to determine the role of the laparoscopic approach in ASBO and to define in which situations it can be beneficial.Methods. We performed a retrospective analysis of a prospectively maintained database of patients who had undergone surgery for ASBO between January 2007 and December 2019. Pre-, intra- and post-operative variables were analysed. Bivariate, logistic regression and a propensity-score matching analyses were performed to compare the laparoscopic and open approach.Results. A total of 333 patients who underwent ASBO surgery were analysed: 224 patients by conventional approach and 109 initially by laparoscopic approach. In the overall analysis, morbidity and mortality were significantly higher in the open group, while the initiation of oral intake and hospital stay were significantly lower in the laparoscopic group. The conversion rate was 36.7%. After propensity-score matching analyses, only the surgeon's laparoscopic skills achieved statistically significant differences between groups in the intention-to treat analysis, but the need for intestinal resection, surgical time, onset of oral intake, hospital stay and morbidity were significantly lower in whom surgery could be completed laparoscopically.Conclusion. The laparoscopic approach is feasible and safe in ASBO, but its advantages are limited to those patients who do not require conversion to open surgery. Both patient selection and the surgeon's expertise in advanced laparoscopic surgery are essential.

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Results of a Laparoscopic Approach for the Treatment of Acute Small Bowel Obstruction due to Adhesions and Internal Hernias

Cited by 5 publications

References 26 publications

Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction

Small Bowel Laparoscopic Resection for Strangulated Umbilical Hernia

Conversion Reduces the Success of Laparoscopic Approach for Adhesive Small Bowel Obstruction. A Propensity-Score Matching Analysis

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