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Minimal invasive surgery for multiple adhesive small bowel obstruction: Results of a comparative multicenter study
Daniel Gómez1,2, Luis F Cabrera2,3, Mauricio Pedraza2,3
1Department of Advanced Laparoscopic Surgery, Centro Policlínico Olaya, Bogotá, Colombia.
Aim Of The Study:
Laparoscopic adhesiolysis in small bowel obstruction (SBO) is getting increasingly normal. In patients with multiple adhesive SBOs (MASBO), laparoscopic approaches might increase the risk of bowel injury due to the distended and potentially compromised small bowel. It remains a challenge to the surgeons, entails an interdisciplinary team, trying to achieve the least complications as possible. The study aimed to compare surgical outcomes of laparoscopic procedures (multi-port vs. single-port) in the management of MASBO.
Patients And Methods:
Comparative study of 68 patients with post-operative MASBO treated with Single-Port single incision laparoscopic surgery (SILS) and Multi-port Laparoscopic Surgery in two centers of Bogota, Colombia between January 2013 and June 2018.
Results:
All patients underwent laparoscopic management, 27 patients by SILS, and 41 patients by multi-port. The average surgical time in the multiport approach was 167 min versus SILS with 129 min. Laparoscopic intestinal resection was performed in 4.4% of patients, through multi-port using intracorporeal anastomosis. Mean hospital stay of 3.2 days for the SILS approach versus multi-port in 2.2 days.
Conclusions:
Both laparoscopic approaches, in MASBO treatment is feasible in qualified hands. Patient selection and medical judgment seem to be the most essential factors for a positive result.
Insights
Single-port (SILS) and multi-port laparoscopic surgery are feasible for managing multiple adhesive small bowel obstructions (MASBO). SILS showed a shorter surgical time and longer hospital stay compared to multi-port procedures.
Area of Science:
- Laparoscopic surgery
- Gastrointestinal surgery
- Surgical outcomes
Background:
- Laparoscopic adhesiolysis for small bowel obstruction (SBO) is common.
- Multiple adhesive SBOs (MASBO) present challenges due to potential bowel compromise.
- Minimizing complications in MASBO management requires careful surgical planning.
Purpose of the Study:
- To compare surgical outcomes of single-port (SILS) versus multi-port laparoscopic surgery for MASBO.
- Evaluate the feasibility and safety of different laparoscopic approaches in MASBO.
Main Methods:
- A comparative study of 68 patients with post-operative MASBO.
- Patients were treated with either SILS or multi-port laparoscopic surgery.
- Data collected from two centers in Bogota, Colombia, between 2013 and 2018.
Main Results:
- SILS was performed in 27 patients; multi-port in 41.
- Average surgical time was 129 min for SILS vs. 167 min for multi-port.
- Mean hospital stay was 3.2 days for SILS vs. 2.2 days for multi-port. Intracorporeal anastomosis was used in 4.4% of multi-port cases.
Conclusions:
- Both SILS and multi-port laparoscopic approaches are feasible for MASBO treatment by experienced surgeons.
- Careful patient selection and clinical judgment are crucial for successful outcomes.
- Laparoscopic management of MASBO can be achieved with minimal complications in expert hands.
