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.
Two Cases of Laparoscopic Adhesiolysis for Chronic Abdominal Pain without Intestinal Obstruction after Total Gastrectomy
