Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN:
1312-773X (Online)
Issue:
2022, vol. 28, issue2
Subject Area:
Medicine
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DOI:
10.5272/jimab.2022282.4405
Published online: 14 June 2022
Original article
J of IMAB. 2022 Apr-Jun;28(2):4405-4408
LAPAROSCOPIC ADHESIOLYSIS-METHOD OF CHOICE IN SELECTED PATIENTS
Konstantin Kostov


,
Department of General, Visceral and Emergency Surgery, UMHATEM "N. I. Pirogov" – Sofia, Bulgaria.
ABSTRACT:
Purpose: The aim of the study is to analyze and estimate the advantages of laparoscopic adhesiolysisin selected patients undergoing laparoscopic adhesiolysis for bowel obstruction in UMHATEM "N.I.Pirogov".
Material and Methods:For a three-year period from 01.01.2016 to 01.01.2019 in the Department of General, Visceral and Emergency surgery in UMHATEM "Pirogov", 42 patients with postoperative intestinal adhesions were operated laparoscopically. Out of the 25 (59.52%) were female.
In our research, parameters - age, gender, clinical symptoms, mode of treatment, morbidity and mortality were analyzed. Age in this retrospective analysis varied from 18 to 61 years (average 43.7 years).
Patients below 18 years of age, and those with tumor data, Crohn's disease and radiation enteritis, were excluded from the study.
Results: Age in this research varied from 18 to 61 (average 43.7). Eleven patients (26.19%) underwent conversion. The causes were dense fibrous adhesions in six of them, iatrogenic lesions in three, and haemorrhage in two cases. In two patients, surgery was performed mini-invasive with an intracorporal suture. The hospital stays varied from 4 to 10 days (on average, 6.3 days). The operating time was from 29 to 121min (an average 57.3min). Surgical morbidity was 28.57%, and mortality was not registered.
Conclusion: Laparoscopic debridement is an excellent and accurate procedure in selected patients with postoperative abdominal adhesions. The last decade has become a method of choice because of its incontrovertible advantages.
Keywords: ileus, postoperative adhesions, laparoscopy, adhesiolysis, conversion,
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Please cite this article as: Kostov K. Laparoscopic adhesiolysis-method of choice in selected patients. J of IMAB. 2022 Jan-Mar;28(1):4405-4408. DOI: 10.5272/jimab.2022282.4405
Correspondence to: Konstantin Kostov, MD, PhD, Surgical Clinic, UMHATEM "N. I. Pirogov"; 21, Totleben Blvd., 1606 Sofia, Bulgaria; E-mail: dr.k.kostov@gmail.com
REFERENCES:
1. Beck DE, Opelka FG, Bailey HR, Rauh SM, Pashos CL. Incidence of small-bowel obstruction and adhesiolysis after open colorectal and general surgery. Dis Colon Rectum. 1999 Feb;42(2):241-8. [PubMed]
2. Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg. 2000 Jul;180(1):33-6. [PubMed]
3. Nagle A, Ujiki M, Denham W, Murayama K. Laparoscopic adhesiolysis for small bowel obstruction. Am J Surg. 2004 Apr;187(4):464-70. [PubMed]
4. Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ. Laparoscopic lysis of adhesions. World J Surg. 2006 Apr;30(4):535-40. [PubMed]
5. Duepree HJ, Senagore AJ, Delaney CP, Fazio VW. Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg. 2003 Aug;197(2):177-81. [PubMed]
6. Pekmezci S, Altinli E, Saribeyoglu K, Carkman S, Hamzaoglu I, Paksoy M, et al. Enteroclysis-guided laparoscopic adhesiolysis in recurrent adhesive small bowel obstructions. Surg Laparosc Endosc Percutan Tech. 2002 Jun;12(3):165-70. [PubMed]
7.Sallinen V, Di Saverio S, Haukijärvi E, Juusela R, Wikström H, Koivukangas V, et al. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomized, open-label trial. Lancet Gastroenterol Hepatol. 2019 Apr;4(4):278-286. [PubMed]
8. Krielen P, Stommel MWJ, Pargmae P, Bouvy ND, Bakkum EA, Ellis H, et al. Adhesion-related readmissions after open and laparoscopic surgery: a retrospective cohort study (SCAR update). Lancet. 2020 Jan 4;395(10217):33-41. [PubMed]
9. Rami Reddy SR, Cappell MS. A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Curr Gastroenterol Rep. 2017 Jun;19(6):28. [PubMed].
Received: 22 June 2021
Published online: 14 June 2022
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