APPLICABILITY OF LAPAROSCOPIC ADIIESIOLYSIS AS A THERAVEUTIC MODALITY FOR POSTOPERATIVE ADHESIVE SMALL BOWEL OBSTRUCTION
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Objectives: The current study was designed to evaluate 11w feasibility and outcome of laparoscopic management of postoperative adhesive small hots el obstruction'. Patients &Methods: The study included 23 patients: 16 males and 7 females With mean age of 41.5±1I.2 years and a mean duration of obstruction of 2.5:0.8 davit The majority of patients (69.6%) had previous appendicectomy'. IA hile the remaining developed after hernial repair. MI patients had preliminary diagnoiic laperoLcopy for identificatign of adhesive bands, and then undement cif rHziry: rtileat:e of the ob:;truclion. . :•: : . • •...i tor cases with a successful applicability kite of Intr T.. I ibigni ',int: ir,copy micceetled to detect the constricting band or the site of adhesions in 21 of 23 cases with a diagnostic success rate of 91.3% and a conversion rate of 8.7"ii due to failure of diagnosis. I.:Taoist:0ply adhesiolysis NVLIS conducted successfully in 18 of 21 patients with a success rate of 85.7% and a conversion rate of 14.3% due to failure of adhesiolysis. All patients had smooth postoperative course, however, patients had laparoscopic adhesiolysis had significantly shorter duration till return of intestinal sounds, resumption of oral intake and hospital stay. Throughout a mean follow-up period of 18.104.22.168: range: 12-28 months, only one patient had laparotontie adhesiolysis developed recurrent small bowel obstruction and underwent successful laparoseopic adhesiolysis. Thus, the total success rate of laparoscopie adhesiolysis was 82.6%, Conclusion: It could be concluded that laparoscopic adhesiolysis is a safe applicable modality for management of small bowel obstruction with adhesiolysis success rate of 82.6% and could be considered as first line of operative management even in recurrent cases.