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[Laparoscopic diagnosis and treatment of acute early adhesive intestinal obstruction]
M E Timofeev1, S E Larichev1, E D Fedorov1
1Research and Education Center of Abdominal Surgery and Endoscopy: Chair of Hospital Surgery No2, N.I. Pirogov Russian National Research Medical University; City Clinical Hospital No31, Moscow.
Aim:
To estimate the role of emergency laparoscopic interventions in diagnosis and treatment of acute early adhesive intestinal obstruction.
Material And Methods:
It is presented the results of diagnostic and curative laparoscopic interventions in 58 patients with suspected acute early adhesive intestinal obstruction after abdominal surgery. Complex clinical-instrumental, non-invasive diagnosis does not always reveal this complication in early postoperative period. Diagnostic laparoscopy was the most informative method to assess state of abdominal cavity, to establish and characterize acute early adhesive intestinal obstruction, to determine following treatment and choice of surgery in all patients.
Results:
Diagnosis of intestinal obstruction was not confirmed in 15 (25.9%) patients based laparoscopic checkup. Acute early adhesive intestinal obstruction was established in 43 (74.1%) patients. Small intestine injuries were observed in 2 (4.5%) cases during laparoscopy. Contraindications to laparoscopic treatment of obstruction were determined in 18 (41.9%) patients in whom conventional operations were performed with complications and death in 7 (38.8%) and 3 (16.6%) cases respectively. Curative laparoscopy was applied in 23 (53.4%) patients with successful resolving of intestinal obstruction and complications in 19 (82.7%) and 4 (17.4%) cases respectively.
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