Laparoscopic versus open surgical management of small bowel obstruction: an analysis of clinical outcomes
- 607 Downloads
Laparotomy is the standard surgical approach for treatment of small bowel obstruction (SBO). Laparoscopic management could be beneficial in terms of less complications and shorter hospital stay. As the minimal invasive approach is gaining more acceptances in the treatment of SBO, there is an increased need of studies to analyze outcomes. The aim of the present study was to compare the short-term clinical outcomes of laparoscopy versus laparotomy in the surgical management of non-bariatric, non-malignant SBO.
A retrospective analysis of patients treated for SBO during 2010–2015 was made by a comprehensive search of medical records. A matched-pair review was performed on patients managed surgically for non-bariatric, non-malignant SBO at Danderyd University Hospital, Stockholm, Sweden. Completed laparoscopic surgeries were matched against patients treated with open surgery.
Laparoscopy for SBO was initiated in 71 patients. Conversion to open surgery was performed in 42 %. Results from the matched-pair analysis showed that post-operative length of stay was reduced by 60 % (P < 0.001) in the laparoscopic cohort. Additionally, less major complications were reported and duration of surgery was reduced by 50 % (P < 0.001).
Laparoscopic management is a safe and feasible alternative to laparotomy. Hospital length of stay was significantly shorter and morbidity rate acceptable.
KeywordsSmall bowel obstruction Laparotomy Laparoscopic surgery Adhesiolysis Outcomes
I extend my gratitude to my coordinator Dr. Björn Salomonsson for the helpful support and valuable feedback during the project.
Compliance with ethical standards
Ann Nordin and Jacob Freedman have no conflicts of interest or financial ties to disclose.
- 3.Maung AA, Johnson DC, Piper GL, Barbosa RR, Rowell SE, Bokhari F, Collins JN, Gordon JR, Ra JH, Kerwin AJ (2012) Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg, United States, pp S362–S369Google Scholar
- 7.Vettoretto N, Carrara A, Corradi A, De Vivo G, Lazzaro L, Ricciardelli L, Agresta F, Amodio C, Bergamini C, Borzellino G, Catani M, Cavaliere D, Cirocchi R, Gemini S, Mirabella A, Palasciano N, Piazza D, Piccoli M, Rigamonti M, Scatizzi M, Tamborrino E, Zago M (2012) Laparoscopic adhesiolysis: consensus conference guidelines. Colorectal Dis 14:e208–e215CrossRefPubMedGoogle Scholar
- 8.Di Saverio S, Coccolini F, Galati M, Smerieri N, Biffl WL, Ansaloni L, Tugnoli G, Velmahos GC, Sartelli M, Bendinelli C, Fraga GP, Kelly MD, Moore FA, Mandala V, Mandala S, Masetti M, Jovine E, Pinna AD, Peitzman AB, Leppaniemi A, Sugarbaker PH, Goor HV, Moore EE, Jeekel J, Catena F (2013) Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg 8(1):42Google Scholar