A retrospective study of laparoscopic surgery for small bowel obstruction.
BACKGROUND
Open laparotomy is widely accepted as the standard surgical treatment for small bowel obstruction (SBO). However, laparoscopic surgery has recently become a treatment option. There is no consensus on the appropriate settings for the laparoscopic treatment of SBO. The purpose of this study is to evaluate the outcomes of laparoscopic surgery for SBO.


METHODS
From January 2012 to May 2016, 48 consecutive patients underwent surgical treatment for SBO in our department. We retrospectively reviewed these cases and compared the features and the outcomes between laparoscopic and open surgery.


RESULTS
Thirty-four and 14 patients underwent open surgery and laparoscopic surgery, respectively. Four of the laparoscopic cases (28.6%) were converted to open surgery. Laparoscopic surgery tended to be associated with a shorter operative time than open surgery (p = 0.066). The first postoperative oral intake was significantly earlier in patients who underwent laparoscopic surgery (p = 0.044). The duration of hospitalization after surgery and the rates of postoperative complications did not differ to a statistically significant extent. Laparoscopic treatment was accomplished in 7 out of 8 cases (87.5%) with SBO due to band occlusion.


CONCLUSIONS
Laparoscopic surgery for SBO is less invasive than open surgery and is equally feasible in selected patients. SBO due to band occlusion may be a preferable indication for laparoscopic surgery. In order to confirm the safety of laparoscopic treatment, and to clarify the appropriate settings for laparoscopic surgery for SBO, it will be necessary to perform further studies in a larger population and with a long follow-up period.
Department of Surgical Oncology, The University of Tokyo, Japan.
Kensuke
K
Otani
Department of Surgical Oncology, The University of Tokyo, Japan.
Soichiro
S
Ishihara
Department of Surgical Oncology, The University of Tokyo, Japan.
Hiroaki
H
Nozawa
Department of Surgical Oncology, The University of Tokyo, Japan.
Kazushige
K
Kawai
Department of Surgical Oncology, The University of Tokyo, Japan.
Keisuke
K
Hata
Department of Surgical Oncology, The University of Tokyo, Japan.
Tomomichi
T
Kiyomatsu
Department of Surgical Oncology, The University of Tokyo, Japan.
Toshiaki
T
Tanaka
Department of Surgical Oncology, The University of Tokyo, Japan.
Takeshi
T
Nishikawa
Department of Surgical Oncology, The University of Tokyo, Japan.
Koji
K
Yasuda
Department of Surgical Oncology, The University of Tokyo, Japan.
Kazuhito
K
Sasaki
Department of Surgical Oncology, The University of Tokyo, Japan.
Koji
K
Murono
Department of Surgical Oncology, The University of Tokyo, Japan.
Toshiaki
T
Watanabe
Laparoscopic surgery; Retrospective study; Small bowel obstruction