Indications for the laparoscopic approach to acute small bowel obstruction: A retrospective review of 50 cases, a literature review, and a single hospital's preliminary experience.
Small bowel obstruction (SBO) is mainly caused by postoperative adhesions, but a broad spectrum of diseases may cause this pathogenetic condition. Laparoscopic treatment represents an efficient approach to SBO. The aim of this paper was to review a single center's experience with a minimally invasive approach to multiple pathologic scenarios causing SBO. From January 2010 to December 2012, 50 consecutive patients underwent laparoscopic surgery for mechanical SBO. In 90% of patients, the surgical procedure was totally laparoscopic, while 10% required conversion to midline laparotomy. In-hospital morbidity was 15% among totally laparoscopic patients and 40% among those who underwent conversion to midline laparotomy. Thirty-day mortality was zero. One patient died 4 months postoperatively from neoplastic disease progression; the remaining patients were free from occlusive symptoms at follow-up. The minimally invasive technique applies to a broad spectrum of cases. A larger cohort of patients seems necessary to reproduce our results and confirm the effectiveness of a laparoscopic approach to SBO.
Department of Surgical and Biochemical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
Francesco
F
Cantarella
Department of Surgery, Local health trust 1 (Azienda Sanitaria Locale), Città di Castello, Italy.
Luca Pio
LP
Evoli
Department of Surgery, Local health trust 1 (Azienda Sanitaria Locale), Città di Castello, Italy.
Claudio
C
Renzi
Department of Surgical and Biochemical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
Emanuel
E
Cavazzoni
Department of Surgery, Local health trust 1 (Azienda Sanitaria Locale), Città di Castello, Italy.
Alessandro
A
Contine
Department of Surgery, Local health trust 1 (Azienda Sanitaria Locale), Città di Castello, Italy.
Maurizio
M
Cesari
Department of Surgical and Biochemical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
Annibale
A
Donini
D000208:Acute Disease; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D007421:Intestine, Small; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome
Incisional hernia; laparoscopic surgery; small bowel obstruction