Early laparoscopic adhesiolysis for small bowel obstruction: retrospective study of main advantages

Mazzetti, Claudia Hannele; Serinaldi, Francesco; Lebrun, E.; Lemaı̂tre, Jean

doi:10.1007/s00464-017-5979-x

Cited by 13 publications

(11 citation statements)

References 31 publications

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“…From a pathophysiological standpoint, it is well accepted that adhesions occur within seven days following the peritoneal injury, becoming progressively organized with brotic tissues. On average, patients must be readmitted twice over the subsequent 10 years due to such adhesions [2,6]. Acute PID primarily cause paralytic ileus, while recurrent chronic pelvic viscera adhesion mainly result in mechanical ileus [4,7].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the most common causes of SBO are intestinal adhesions, tumors, hernias, and in ammatory bowel disease, 10% of which may be further due to infection or in ammation (e.g. appendicitis, diverticulitis, endometriosis, pelvic in ammatory disease (PID), intestinal disease, abdominal tuberculosis), or chemical peritonitis and irritation caused by foreign bodies [2,3]. Thirty-three percent of SBO occur in the rst year following the triggering factor [2].…”

Section: Introductionmentioning

confidence: 99%

“…appendicitis, diverticulitis, endometriosis, pelvic in ammatory disease (PID), intestinal disease, abdominal tuberculosis), or chemical peritonitis and irritation caused by foreign bodies [2,3]. Thirty-three percent of SBO occur in the rst year following the triggering factor [2]. Tubo-ovarian abscess (TOA), a complication of PID, can be severe and life-threatening.…”

Section: Introductionmentioning

confidence: 99%

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Small Bowel Obstruction Caused by Tubo-Ovarian Abscess Following Chronic Pelvic Inflammatory Disease: A Case Report

Zhang

Zhao

et al. 2021

Preprint

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BackgroundAlthough there are reports of small bowel obstruction (SBO) secondary to tubo-ovarian abscess (TOA), there have been no documented cases of unexpected SBO, multiple intestinal ruptures and adhesions in a patient with chronic PID followed by successful surgical treatment of TOA who was successfully treated by surgery after failure by conservative treatment.Case presentationA 40-year-old female was admitted with main complaint of abdominal pain and fever for six days. A pelvic mass measuring 6.37x7.85x9.04 cm and ascites at rectovaginal pouch were found despite local treatment with metronidazole and cefazolin. Laboratory tests revealed leukocytosis of 8.9x10^9/L with hyper-neutrocytophilia of 82.8%, C-reactive protein increase at 223 mg/L and Procalcitonin 0.14ng/L. The patient was diagnosed with an acute attack of chronic PID. Tests and body temperature improved after 4 days of IV antibiotics. However, two days later, the patient presented abdominal distension, poor appetite, and difficulty in defecation. Abdominal CT suggested possibility of bowel obstruction. Accordingly, an explorative laparoscopy was performed, revealing 500ml pale yellow ascites within the abdominal cavity. The intestinal tube was clearly dilated with poor peristalsis. Multiple intestinal ruptures and adhesions were found. Dense adhesion existed between the intestinal loop and posterior uterus wall, closing the rectouterine pouch. Pale yellow thick pus could be seen from the end of fallopian tube, and part of the right ovary showed serious pyosis. All the adhesions were split, ruptures were repaired and normal anatomy was restored. Postoperative pathology indicated acute and chronic inflammation of both fallopian tubes with focal abscess formation. The patient was discharged 15 days after operation and followed up at one month without any symptoms.ConclusionIn such cases, close attention should be paid to changes in the patient’s condition and lesion changes. Early laparoscopy is advised when there are significant clinical or CT scan signs of bowel obstruction in TOA patients. Precise predictors or a predictive model for the need of invasive intervention to TOA will require further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Small Bowel Obstruction Caused by Tubo-Ovarian Abscess Following Chronic Pelvic Inflammatory Disease: A Case Report

Zhang

Zhao

et al. 2021

Preprint

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“…Placing anti-AA barriers is costly and needs extra operative time, therefore barriers positioning should be preferentially targeted in selected high-risk cases 35 . Patients with AA and chronic abdominal pain have been approached with laparoscopic adhesiolysis but the procedure is still controversial, often causing other AA in a vicious circle and it is not clear if adhesiolysis leads to a substantial pain relief, preservation of female fertility or improvement in quality of life 36 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Inherited genetic predispositions in F13A1 and F13B genes predict abdominal adhesion formation: identification of gender prognostic indicators

Gemmati

Occhionorelli

Tisato

et al. 2018

Sci Rep

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Abdominal adhesions (AA) account for the most common complication of peritoneal surgery with bowel obstruction being the severest problem in the absence of effective predicting biomarkers. Anti-AA-barriers or adhesiolysis did not completely prevent bowel obstruction, although there is evidence they might reduce related complications requiring reoperation. In addition, gender-related predispositions have not been adequately investigated. We explored the role of coagulation Factor XIII (F13A1 and F13B subunit-genes) in patients following laparotomy, mostly median/lower median incision line. Globally, 426 patients (54%,♀), were PCR-SNP-genotyped for FXIIIA V34L (rs5985), FXIIIA P564L (rs5982), FXIIIA Y204F (rs3024477) and FXIIIB H95R (rs6003). Patients’ clinical phenotypes were: Group-A (n = 212), those who developed AA, and 55.2% of them developed bowel obstruction (subgroup-A1), the remaining were subgroup-A2; Group B (n = 214) were those who did not develop AA (subgroup-B1; 53.3%) or symptoms/complications (subgroup-B2). Among different laparotomy, colon surgery associated with AA at a major extent (OR = 5.1; 3.24–7.8; P < 0.0001) with different gender scores (♀OR = 5.33; 2.32–12.23; P < 0.0001 and ♂OR = 3.44; 1.58–7.49; P < 0.0001). Among SNPs, P564L (OR = 4.42; 1.45–13.4; P = 0.008) and Y204F (OR = 7.78; 1.62–37.3; P = 0.01) significantly predicted bowel obstruction and survival-analyses yielded interesting gender distinctions (♀HR = 5.28; 2.36–11.8; P = 0.00005; ♂HR = 2.22; 1.31–3.85; P = 0.0034). Active compounds preventing AA belong to the anticoagulant/fibrinolysis areas, suggesting them candidate investigation targets. We identified novel prognostic markers to predict AA/bowel obstruction giving insights to design novel therapeutic and gender prevention programs.

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“…1 Experienced laparoscopic surgeons extended their applications and performed laparoscopy for SBO surgeries. 2 Multiple studies and reports comparing laparoscopy and open surgery have revealed safety and feasibility of laparoscopic surgery and also postoperative short-term advantages of laparoscopic treatment for SBO including less postoperative pain, and faster recovery. 3 Furthermore, single port laparoscopic surgery also is being used for the maximal benefits of minimally invasive surgery.…”

Section: Editorialmentioning

confidence: 99%

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

Lee

2018

J Minim Invasive Surg

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Early laparoscopic adhesiolysis for small bowel obstruction: retrospective study of main advantages

Abstract: Early laparoscopic surgery can be proposed as an effective alternative treatment for ASBO.

Cited by 13 publications

References 31 publications

Small Bowel Obstruction Caused by Tubo-Ovarian Abscess Following Chronic Pelvic Inflammatory Disease: A Case Report

Small Bowel Obstruction Caused by Tubo-Ovarian Abscess Following Chronic Pelvic Inflammatory Disease: A Case Report

Inherited genetic predispositions in F13A1 and F13B genes predict abdominal adhesion formation: identification of gender prognostic indicators

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

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