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[A preliminary experience in the laparoscopic approach to bowel obstruction]
C Fortea-Sanchis1, P Priego-Jiménez1, D Martínez-Ramos1
1Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, España.
Background:
The laparoscopic approach to bowel obstruction is still controversial.
Objective:
To evaluate our initial results in the laparoscopic treatment of bowel obstruction.
Material And Methods:
A retrospective study on patients diagnosed with bowel obstruction that underwent laparoscopic surgery within the time frame of January 2008 to June 30, 2012. The variables employed were: age, sex, occlusion etiology, previous surgeries, clinical progression, pneumoperitoneum creation, use of an auxiliary incision, anesthesia duration, conversion rate, postoperative hospital stay, time needed to tolerate liquids, and complications.
Results:
Twenty-six patients, 18 women (69.2%) and 8 men (30.8%), with a mean age of 64.35 years (range: 21-92 years) were analyzed. The most frequent obstruction etiology was secondary to adhesions and presented in 12 cases. Nine patients (34.6%) underwent a completely laparoscopic approach and laparoscopy was complemented by an auxiliary incision in another 9 patients (34.6%), resulting in 18 cases (69.2%) of successful laparoscopic approach. Eight patients (30.8%) required conversion to open surgery. The mean anesthesia duration was 95min (range: 55-165min), mean postoperative hospital stay was 6 days (range: 3-72 days), and the mean amount of time needed to tolerate liquids was 3 days (range: 1-10 days). The patients that underwent complete laparoscopic approach presented with shorter hospital stay, they were able to ingest liquids earlier, and they presented with a lower number of postoperative complications; this latter variable was the only one that was statistically significant.
Conclusions:
The initial results of our experience were good, although more patients are needed in order to standardize and extend the use of this technique.
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