title: [Laparoscopic approach to the "acute" and "chronic" bowel obstruction].
abstract: OBJECTIVE
  To retrospectively evaluate a series of patients with acute and chronic small bowel obstruction and discuss the indications of laparoscopic vs laparotomic approach and the outcome of both these techniques.
  
  
  METHODS
  85 patients with acute and chronic small bowel obstruction who underwent to either emergency or elective surgery since January 1999 up to October 2001 were enrolled. Subjects were divided into three groups: 39 treated with emergency laparotomy (group I), 13 with emergency laparoscopy (group II) and 33 with elective laparoscopy for chronic/subacute obstructions (group III).
  
  
  RESULTS
  1) the most frequent indication of the laparotomic approach was either multiple or major previous surgery as well as neoplastic diseases; 2) patients of the second group had frequently previous either minor or laparoscopic surgery; 3) the incidence of previous emergency surgery were maximum among the III group; 4) both post-operative ileus and mean hospital stay lasted less in the II than in the I group. The mean operative time and the morbidity was equal in the two groups; 5) we observed more intra-operative complications, a higher conversion rate and a longer both post-operative ileus and mean hospital stay in the II than in the III group.
  
  
  CONCLUSIONS
  Our data support the role of laparoscopy in patients with chronic/subacute small bowel obstruction. Patients with acute obstruction may undergo laparoscopy after a careful selection, excluding subjects with previous either multiple or major surgery as well as neoplastic diseases. Such results need future confirmations from prospective randomized studies.
authors.affiliation: Azienda Ospedaliera Careggi Firenze.
authors.forename: C
authors.initials: C
authors.lastname: Bergamini
authors.forename: A
authors.initials: A
authors.lastname: Borrelli
authors.forename: M
authors.initials: M
authors.lastname: Lucchese
authors.forename: G
authors.initials: G
authors.lastname: Manca
authors.forename: L
authors.initials: L
authors.lastname: Presenti
authors.forename: S
authors.initials: S
authors.lastname: Reddavide
authors.forename: P
authors.initials: P
authors.lastname: Tonelli
authors.forename: A
authors.initials: A
authors.lastname: Valeri
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome