Does laparoscopic adhesiolysis decrease the risk of recurrent symptoms in small bowel obstruction? A propensity score-matched analysis

2017 ◽  
Vol 31 (12) ◽  
pp. 5348-5355 ◽  
Author(s):  
Siyuan Yao ◽  
Eiji Tanaka ◽  
Yugo Matsui ◽  
Atsushi Ikeda ◽  
Teppei Murakami ◽  
...  
Keyword(s):  
Small Bowel ◽  
Propensity Score ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Laparoscopic Adhesiolysis

scholarly journals Laparoscopic versus Open Surgery for Acute Adhesive Small-Bowel Obstruction: A Propensity Score–Matched Analysis

2016 ◽  
Vol 106 (1) ◽  
pp. 28-33 ◽  
Author(s):  
T. Hackenberg ◽  
P. Mentula ◽  
A. Leppäniemi ◽  
V. Sallinen
Keyword(s):  
Small Bowel ◽  
Propensity Score ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Adhesive Small Bowel Obstruction ◽  
Open Approach ◽  
Laparoscopic Adhesiolysis

Background and Aims: The laparoscopic approach has been increasingly used to treat adhesive small-bowel obstruction. The aim of this study was to compare the outcomes of a laparoscopic versus an open approach for adhesive small-bowel obstruction. Material and Methods: Data were retrospectively collected on patients who had surgery for adhesive small-bowel obstruction at a single academic center between January 2010 and December 2012. Patients with a contraindication for the laparoscopic approach were excluded. A propensity score was used to match patients in the laparoscopic and open surgery groups based on their preoperative parameters. Results: A total of 25 patients underwent laparoscopic adhesiolysis and 67 patients open adhesiolysis. The open adhesiolysis group had more suspected bowel strangulations and more previous abdominal surgeries than the laparoscopic adhesiolysis group. Severe complication rate (Clavien–Dindo 3 or higher) was 0% in the laparoscopic adhesiolysis group versus 14% in the open adhesiolysis group ( p = 0.052). Twenty-five propensity score–matched patients from the open adhesiolysis group were similar to laparoscopic adhesiolysis group patients with regard to their preoperative parameters. Length of hospital stay was shorter in the laparoscopic adhesiolysis group compared to the propensity score–matched open adhesiolysis group (6.0 vs 10.0 days, p = 0.037), but no differences were found in severe complications between the laparoscopic adhesiolysis and propensity score–matched open adhesiolysis groups (0% vs 4%, p = 0.31). Conclusion: Patients selected to be operated by the open approach had higher preoperative morbidity than the ones selected for the laparoscopic approach. After matching for this disparity, the laparoscopic approach was associated with a shorter length of hospital stay without differences in complications. The laparoscopic approach may be a preferable approach in selected patients.

Selective Laparoscopic Management of Adhesive Small Bowel Obstruction Using CT Guidance

2009 ◽  
Vol 75 (3) ◽  
pp. 227-231 ◽  
Author(s):  
In Kyu Lee ◽  
Do Hyoung Kim ◽  
D. Lee Gorden ◽  
Yoon Suk Lee ◽  
Seung Eun Jung ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Medical Center ◽  
Preoperative Imaging ◽  
Adhesive Small Bowel Obstruction ◽  
Abdominal Ct ◽  
Laparoscopic Adhesiolysis ◽  
Adhesive Band

Small bowel obstruction after intra-abdominal surgery is a common cause of morbidity necessitating reoperation. The aim of this study was to determine the feasibility of and indications for laparoscopic surgery for acute adhesive small bowel obstruction (AASBO). We conducted a retrospective review of all patients with AASBO who underwent laparoscopic adhesiolysis at a major university medical center. Laparoscopic treatment was performed successfully in 16 patients, and conventional treatment was performed in 13 patients. The rate of conversion from laparoscopic to open was 16.7 per cent. In 15 of 16 total patients who underwent laparoscopic surgery, laparoscopic bandlysis was performed and one patient underwent laparoscopic adhesiolysis. Laparoscopic surgery was performed successfully in nine who had a single adhesive band demonstrated on an abdominal CT, and conventional surgery was performed in all 10 patients without a single adhesive band identified radiographically. Abdominal CT scans facilitate the selection of operative approach for AASBO based on preoperative identification of the obstruction site. Laparoscopic adhesiolysis is a safe and effective treatment modality for patients with AASBO with a single band or single transition zone identified by preoperative imaging.

scholarly journals Effect of the Japanese Herbal Kampo Medicine Dai-Kenchu-To on Postoperative Adhesive Small Bowel Obstruction Requiring Long-Tube Decompression: A Propensity Score Analysis

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Hideo Yasunaga ◽  
Hiroaki Miyata ◽  
Hiromasa Horiguchi ◽  
Kazuaki Kuwabara ◽  
Hideki Hashimoto ◽  
...  
Keyword(s):  
Small Bowel ◽  
Propensity Score ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Propensity Score Analysis ◽  
Kampo Medicine ◽  
Hospital Charges ◽  
Adhesive Small Bowel Obstruction ◽  
Success Rates ◽  
Colorectal Cancer Surgery

Adhesive small bowel obstruction (ASBO) is an adverse consequence of abdominal surgery. Although the Kampo medicine Dai-kenchu-to is widely used in Japan for treatment of postoperative ASBO, rigorous clinical studies for its use have not been performed. In the present retrospective observational study using the Japanese diagnosis procedure combination inpatient database, we selected 288 propensity-score-matched patients with early postoperative ASBO following colorectal cancer surgery, who received long-tube decompression (LTD) with or without Dai-kenchu-to administration. The success rates of LTD were not significantly different between Dai-kenchu-to users and nonusers (84.7% versus 78.5%;P=.224), while Dai-kenchu-to users showed a shorter duration of LTD (8 versus 10 days;P=.012), shorter duration between long-tube insertion and discharge (23 versus 25 days;P=.018), and lower hospital charges ($23,086 versus$26,950;P=.018) compared with Dai-kenchu-to nonusers. In conclusion, the present study suggests that Dai-kenchu-to is effective for reducing the duration of LTD and saving costs.

The Role of Laparoscopy in Small Bowel Obstruction After Previous Laparotomy for Trauma: An Initial Report

2011 ◽  
Vol 77 (2) ◽  
pp. 184-187
Author(s):  
Jon D. Simmons ◽  
Emily A. Rogers ◽  
John M. Porter ◽  
Naveed Ahmed
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Transition Zone ◽  
Bowel Obstruction ◽  
Laparoscopic Approach ◽  
Effective Characteristics ◽  
Initial Report ◽  
Laparoscopic Adhesiolysis ◽  
Previous Laparotomy

Presently, there are no guidelines to help predict which patients are more likely to have successful laparoscopic adhesiolysis. We attempt to define which preoperative characteristics of trauma patients who later develop small bowel obstruction are most amenable to a laparoscopic operation. We did a retrospective review of all patients with small bowel obstruction after previous laparotomy for trauma. For the patients that received an operation to relieve the obstruction, the location of transition zone via CT scan and location of the previous abdominal scar were recorded. A previous upper abdominal surgical incision and a transition zone outside of the pelvis on CT scan were preoperative predictors of a successful laparoscopic adhesiolysis. The laparoscopic group had a shorter length of stay. Laparoscopic surgery as the initial operative approach in the management of SBO after previous laparotomy for trauma is safe and effective. Characteristics that make the laparoscopic approach most favorable are CT transition point above the pelvis and previous midline incision above umbilicus.

Laparoscopic adhesiolysis for small bowel obstruction

2004 ◽  
Vol 187 (4) ◽  
pp. 464-470 ◽  
Author(s):  
Alexander Nagle ◽  
Michael Ujiki ◽  
Woody Denham ◽  
Kenric Murayama
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Laparoscopic Adhesiolysis

Impact of hospital volume on outcomes for laparoscopic adhesiolysis for small bowel obstruction

2017 ◽  
Vol 214 ◽  
pp. 23-31 ◽  
Author(s):  
Raymond A. Jean ◽  
Kathleen M. O'Neill ◽  
Kevin Y. Pei ◽  
Kimberly A. Davis
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Hospital Volume ◽  
Laparoscopic Adhesiolysis

scholarly journals Laparoscopic Adhesiolysis - An Initial Experience of 15 Cases

2010 ◽  
Vol 15 (Number 2) ◽  
pp. 3-8
Author(s):  
B U Khan ◽  
A Azim ◽  
S Baemon ◽  
S I Khan
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Chronic Abdominal Pain ◽  
High Rate ◽  
Adhesive Small Bowel Obstruction ◽  
Surgical Trauma ◽  
College Hospital ◽  
Laparoscopic Adhesiolysis

Post-operative adhesions frequently occur and can account for various symptoms like chronic abdominal pain and small bowel obstruction. Conventional adhesiolylis by laparotomy results in an unacceptably high rate of recurrence. A minimally invasive procedure (laparoscopic adhesiolysis) might improve she outcome by inflicting less surgical trauma, but well-documented reports focusing on laparoscopic adhesiolysis for chronic abdominal pain and small bowel obstruction is lacking. The aim of this study was to evaluate the efficiency. safety. and outcome of laparoscopic adhesiolysis for recurrent adhesive small-bowel obstruction. Eighty nine patiencs (median age 48 years: range: 25-83 years) operated for small bowel obstruction and chronic abdominal pain in the Depanment of General Surgery, Holy Family Red Crescent Medical College hospital were included for the study. Pre-pensive urgent blood teas and ubdontinal s- ay were done in all patients; 74 patients were treated with traditional laparotomy, while 15 selected patients underwent laparoscopy. For one (6.67%) of the 15 patients treated wits laparoscopy a conversion was necessmy because of the adhesion localization in the posterior abdominal wall, The median stay in hospital was 4.7 days for patients who underwent laparoscopy and 14.3 days for patients treated by traditional laparotonsy. Only one (6.67%) case in laparoscopv group needed to be re-operated, while five (6.76%) cases in laparntonty group needed to be re-operated because of recurrence of obstruction by new adhesions. Overall number of complications contributing to morbidity were significantly lower in those who underwent laparoscopic adhesiolysis. Laparoscopic adhesiolysis is an effective treatment for small bowel obsommion, morbidity is lower. hospital stay is shorter. and resumption of a novael diet is foster.

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