title: The role of laparoscopic surgery for the management of acute large bowel obstruction.
abstract: OBJECTIVE
  The aim of this study was to analyse the outcome of laparoscopic management of large bowel obstruction (LBO).
  
  
  METHODS
  A prospective electronic database (April 2001-June 2009) was used to identify outcomes in consecutive patients presenting with LBO.
  
  
  RESULTS
  Twenty-four patients (13 male) median age 68 years (range 56-92 years), ASA grade I (2), II (6), III (14) and IV (2), underwent surgery for LBO secondary to cancer (21) and diverticulosis (3). Supervised trainees performed four operations. Operations included anterior resection (10), Hartmann's resection (6), right/extended hemicolectomy (7) and colectomy with ileorectal anastomosis (1). The median operating time was 100 min (range 65-180 min). There were two (8%) conversions. The median time to normal diet was 24 h (range 2-192 h) and median hospital stay 3 days (range 1-30 days). Complications, seen in six patients, included atrial fibrillation (2), wound infection (2), ileus (2), CO(2) retention (1), stoma necrosis (1), circulatory collapse/bowel ischaemia (1) and anastomotic leak (1). There was one (4%) readmission and two (8%) returns to theatre. One patient died.
  
  
  CONCLUSIONS
  Laparoscopic resectional surgery in acute LBO is feasible and safe with a low complication rate that enables early hospital discharge.
authors.affiliation: Department of Colorectal Surgery, Frenchay Hospital, Bristol, UK.
authors.forename: K
authors.initials: K
authors.lastname: Gash
authors.forename: W
authors.initials: W
authors.lastname: Chambers
authors.forename: A
authors.initials: A
authors.lastname: Ghosh
authors.forename: A R
authors.initials: AR
authors.lastname: Dixon
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications*; D004240:Diverticulum / Q000150:complications*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome