Laparoscopy and small bowel obstruction in children.
Three issues are studied: 1. What is well-known about post-operative small bowel obstructions. The cost of this pathology, the complications associated (blood loss, enterocutaneous fistulas, major bowel resections, abdominal wall damages, death), the distribution of adhesions in the abdominal cavity, and previous surgeries. 2. Small bowel obstructions happen after laparoscopy and the incidence is more than 1% of patients: herniation of the small bowel through a trocar site, herniation of the omentum through a trocar site, peritoneal defect, spillage of stones and stercolitis. Suggestions to avoid small bowel obstruction after laparoscopy include the use of smaller trocars whenever possible, repairing the fascia under direct vision, carefully desufflating the abdominal cavity, avoiding bleeding, spilled stones and staples and washing the abdominal cavity at the end of the surgical procedure. 3. The treatment of small obstruction is feasible by laparoscopy, reliability, and results are studied with a multicentric GECI (Groupe d'Etude en Coelioscopie Infantile) and literature series. We obtained good results for 2/3 children.
Becmeur
Francois
F
Department of Pediatric Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France. francois.becmeur@chru-strasbourg.fr
D002648:Child; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000517:prevention & control; D007421:Intestine, Small; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D010372:Pediatrics / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome