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 21.31.1.6: 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. |
