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Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

  • Franziska Carmen Grafen
  • Valentin Neuhaus
  • Othmar Schöb
  • Matthias TurinaEmail author
Original Article

Abstract

Purpose

The aim of this study is to compare the results of laparoscopic management of acute small bowel obstruction (SBO) from abdominal adhesions to both exploratory laparotomy and secondary conversion to open surgery.

Materials and methods

Ninety-three patients (mean age 61 years) with adhesion-induced SBO were divided into successful laparoscopy (66 patients [71%]), secondary conversion (24 [26%]), and primary laparotomy (three patients).

Results

Patients with successful laparoscopy had more simple adhesions (57%), fewer prior operations, and lower American Society of Anesthesiologists (ASA) class. Operative time was shortest in the laparoscopy group (74.3 ± 4.4 min), as was the duration of both intensive care unit and hospital stay. Mortality was 6%, regardless of operative technique.

Conclusions

A trial of laparoscopic adhesiolysis by a surgeon with advanced laparoscopic skills seems advisable in the majority of patients with acute adhesive SBO, whereas patients with more extensive adhesions, higher ASA class, and more than two prior abdominal operations often require laparotomy to achieve equally satisfactory outcome.

Keywords

Small bowel Obstruction Ileus Laparoscopy Intestinal Operation Adhesion 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Franziska Carmen Grafen
    • 1
  • Valentin Neuhaus
    • 1
  • Othmar Schöb
    • 1
  • Matthias Turina
    • 1
    • 2
    Email author
  1. 1.Department of SurgeryLimmattal HospitalSchlierenSwitzerland
  2. 2.Department of SurgeryUniversity of Zürich HospitalZürichSwitzerland

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