Laparoscopic Adhesiolysis in Acute Mechanical Intestinal Obstruction Due to Adhesion

Objective: The aim of the study was to discuss our clinical experience of laparoscopic adhesiolysis in acute mechanical bowel obstruction (MBO) due to post-operative adhesion in the light of the literature. Methods: Patients who underwent laparoscopic adhesiolysis due to acute MBO due to adhesion between January 2014 and December 2019 were included in the study. Diagnosis of acute MIO was put with patient’s history, clinical examination findings, standing direct abdominal radiography, and computed tomography. Laparoscopic adhesyolysis was applied to those who did not respond to conservative treatment at the end of 24–48 h. Results: Twenty-four patients with laparoscopic adhesiolysis were included in the study. Sixteen of the patients were women and eight were men. The average age was 52 years (27–74). Post-operative MBO due to adhesion and dilatation in the proximal of the adhesion was observed in the distal ileum in 14 patients, in the proximal jejunum in ten patients. For 4 (16.7%) patients, it was switched to open surgery due to technical difficulties. Douglas drain was placed in seven of the patients to monitor the risk of possible bleeding and intestinal perforation. Oral intake was started in patients whose abdominal pain and nausea complaints regressed on the 1st post-operative day. Patients were discharged after an average post-operative 4.2 (2–8) days. Loop ileostomy was performed in one patient, when intestinal contents came from the drain on the post-operative on the 3rd day. Post-operative mortality was not observed in any of our patients. Conclusion: In light of the increasing use of laparoscopic surgery in recent years, due to the disadvantages of the conventional surgical method in acute MBO due to post-operative adhesion, we believe that the laparoscopic approach will safely become widespread.

Kaynakça

1. William A, Michael G. Intestinal Obstruction. In: George Zuidema, editor. Shackelford’s Surgery of the Alimentary Tract. Philadelphia: WB Saunders; 1996. p. 375–416.

2. van den Beukel BA, de Ree R, van Leuven S, Bakkum EA, Strik C, van Goor H, et al. Surgical treatment of adhesion-related chronic abdominal and repelvic pain after gynaecological and general surgery: a systematic review and meta-analysis. Human Reprod Update 2017;23:276–88.

3. Perry JF Jr, Smith Ga, Yonehiro Eg. Intestinal Obstruction caused by adhesion. Ann Surg 1955;142:810–6.

4. Alfred SG, Charles LP. Serosal Hipofibrinoliysis. Am J Surg 1973;125:80–8.

5. Okabayashi K, Ashrafian H, Zacharakis E, Hasegawa H, Kitagawa Y, Athanasiou T, et al. Adhesions after abdominal surgery: a systematic review of the incidence, distribution and severity. Surg Today 2014;44:405–420.

6. Yesildaglar N, Koninckx PR. Adhesion formation in intubated rabbits increases with high insufflation pressure during endoscopic surgery. Hum Reprod 2000;15:687–91.

7. Luijendijk DC. Foreign materials in postoperative adhesions. Ann Surg 1996;223:242–8.

8. Randall D, Joosten F, ten Broek RP, Gillott R, Bardhan KD, Strik C, et al. A novel diagnostic aid for intra-abdominal adhesion detection in cine-MR imaging: Pilot study and initial diagnostic impressions. Br J Radiol 2017:20170158.

9. Gerner-Rasmussen J, Donatsky AM, Bjerrum F. The role of non-invasive imaging techniques in detecting intra-abdominal adhesions: a systematic review. Langenbecks Arch Surg 2019;404:653–61.

10. Nagle A, Ujiki M, Denham W, Murayama K. Laparoscopic adhesiolysis for small bowel obstruction. Am J Surg 2004;187:464–70.

11. Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ. Laparoscopic lysis of adhesions. World J Surg 2006;30:535–40.

12. Sajid MS, Khawaja AH, Sains P, Singh KK, Baig MK. A systematic review comparing laparoscopic vs open adhesiolysis in patients with adhesional small bowel obstruction. Am J Surg 2016;212:138–50.

13. Liauw JJ, Cheah WK. Laparoscopic management of acute small bowel obstruction. Asian J Surg 2005;28:185–8.

14. Saribeyoğlu K, Pekmezci S, Korman U, Kol E, Baca B, Günay S. Selective laparoskopic adhesiolysis in the management of acute and chronic recurrent adhesive bowel obstruction. Ulus Travma Acil Cerrahi Derg 2008;14:28–33.

15. Borzellino G, Tasselli S, Zerman G, Pedrazzani C, Manzoni G. Laparoscopic approach to postoperative adhesive obstruction. Surg Endosc 2004;18:686–90.

16. Francois Y, Mouret P, Tomaoglu K, Vignal J. Postoperative adhesive peritoneal disease. Laparoscopic treatment. Surg Endosc 1994;8:781–3.

17. Kirshtein B, Roy-Shapira A, Lantsberg L, Avinoach E, Mizrahi S. Laparoscopic management of acute small bowel obstruction. Surg Endosc 2005;19:464–7.

18. Strickland P, Lourie DJ, Suddleson EA, Blitz JB, Stain SC. Is laparoscopy safe and effective for treatment of acute small-bowel obstruction? Surg Endosc 1999;13:695–8.

19. Chosidow D, Johanet H, Montariol T, Kielt R, Manceau C, Marmuse JP, et al. Laparoscopy for acute small-bowel obstruction secondary to adhesions. J Laparoendosc Adv Surg Tech A 2000;10:155–9.

20. Malik E, Berg C, Meyhöfer-Malik A, Haider S, Rossmanith WG. Subjective evaluation of the therapeutic value of laparoscopic adhesiolysis: a retrospective analysis. Surg Endosc 2000;14:79–81.

21. Yuvaci HU, Cevrioğlu AS, Gündüz Y, Akdemir N, Karacan A, Erkorkmaz Ü, et al. Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions? Turk J Med Sci 202;50:304–11.

22. Ziprin P, Ridgway PF, Peck DH, Darzi AW. Laparoscopic-type environment enhances mesothelial cell fibrinolytic activity in vitro via a down-regulation of plasminogen activator inhibitor-1 activity. Surgery 2003;134:758–65.

23. Suter M, Zermatten P, Halkic N, Martinet O, Bettschart V. Laparoscopic management of mechanical small bowel obstruction: are there predictors of success or failure? Surg Endosc 2000;14:478–83.

24. Hackenberg T, Mentula P, Leppäniemi A, Sallinen V. Laparoscopic versus Open Surgery for Acute Adhesive Small-Bowel Obstruction: A Propensity Score–Matched Analysis. Scand J Surg 2017;106:28– 33.

25. Sallinen V, Di Saverio S, Haukijärvi E, Juusela R, Wikström H, Koivukangas V, et al. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomised, open-label trial. Lancet Gastroenterol Hepatol 2019;4:278–86.

Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

653117

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