title: Outcomes of laparoscopic management of acute small bowel obstruction: a 7-year experience of 110 consecutive cases with various etiologies.
abstract: OBJECTIVE
  Laparoscopic surgery is emerging as an alternative to open surgery for treating acute small bowel obstruction (SBO). While postoperative adhesion is the most frequent etiology, the optimum treatment for all types of SBO needs to be evaluated.
  
  
  METHODS
  A retrospective review was performed of 110 consecutive patients who underwent laparoscopic surgery at our institution between 2009 and 2015. The short-term outcomes included perioperative factors, while the long-term outcome included the recurrence rate.
  
  
  RESULTS
  Of the 110 patients, 55 were female. The median age at surgery was 69.5 years. Laparoscopic surgery was completed in 91.8 %. The median operative time was 82 min, median amount of bleeding was 0 ml, and median postoperative hospital stay was 8 days. Intraoperative major organ injury was seen in 2.7 %. The complication rate (Clavien-Dindo ≥ class II) was 8.2 %, and the mortality rate was 3.6 %. The recurrence rate was 8.2 %. Only dense and matted adhesion was a predictive factor for conversion (OR 30.244).
  
  
  CONCLUSIONS
  Good short-term outcomes and feasible long-term outcomes were achieved with a laparoscopic approach to treating acute SBO. It was a safe and effective method, especially in patients with isolated bands, simple enteral angulation, and foreign body or tumor, while dense and matted adhesions were still challenging.
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan. siyuan@kobe-nishishimin-hospi.jp.
authors.forename: SiYuan
authors.identifier: http://orcid.org/0000-0002-6770-5297
authors.initials: S
authors.lastname: Yao
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ikeda
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Okumoto
authors.affiliation: Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Harada
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult
keywords: Laparoscopic surgery; Outcome; Small bowel obstruction