Nationwide Impact of Laparoscopic Lysis of Adhesions in the Management of Intestinal Obstruction in the US

Mancini, Gregory J.; Petroski, Gregory F.; Lin, Wen‐Chieh; Sporn, Emanuel; Miedema, Brent W.; Thaler, Klaus

doi:10.1016/j.jamcollsurg.2008.04.026

Cited by 62 publications

(48 citation statements)

References 16 publications

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“…Our conversion rate of 30% compares favorably to existing reports in which conversion rates range from 6.7% to 43% [20,[22][23][24]. The comparably low conversion rate of 17% by Mancini et al in their study of 6,165 patients with adhesion-related SBO may be explained by the low initial percentage (11%) of patients treated laparoscopically, indicating a positive selection of patients amenable to successful laparoscopic adhesiolysis [5]. As stated by the authors, patients undergoing laparoscopy were significantly more likely to be women, younger, have less comorbidity, and have private health care insurance.…”

Section: Discussionsupporting

confidence: 66%

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Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Grafen

Neuhaus

Schöb

et al. 2009

Langenbecks Arch Surg

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Section: Discussionsupporting

confidence: 66%

“…A recent large study by Mancini et al found that, in the United States, only 11% of patients with adhesion-related SBO from the 2002 National Inpatient Sample were treated laparoscopically [5]. Laparotomy is regarded as a proven and reliable, albeit often demanding, procedure with significant morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Grafen

Neuhaus

Schöb

et al. 2009

Langenbecks Arch Surg

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“…1,22,23 Since the first report of Bastug et al for successful laparoscopic adhesiolysis in 1991, 9 technological developments and increased experience with LS have led to a number of studies reporting advantages of LS, including a shorter postoperative hospital stay, fewer complications, and less postoperative pain. [10][11][12][13][14][15][16][17] Kim et al reported significant reductions in return of bowel function (4.3 vs. 6.6 days, p=0.02), and hospital stay (8.1 vs. 15.2 days, p=0.04). 17 Moreover, in a systematic review comparing laparoscopic adhesiolysis with open adhesiolysis for SBO treatment, LS resulted in reduced risks of morbidity, mortality, and surgical site infection.…”

Section: Discussionmentioning

confidence: 97%

“…9 Since then, with the recent technical advances and increased experience in LS, many previous studies have shown the safety, feasibility, and potential superiority of a laparoscopic approach for the treatment of SBO. [10][11][12][13][14][15][16][17] Moreover, some studies have reported long-term outcomes, such as the frequency and management of recurrence after LS. [18][19][20] Despite many studies have been reported on safety of laparoscopic adhesiolysis in SBO, prospective randomized trials comparing LS and OS in the treatment of SBO have not been published.…”

Section: Introductionmentioning

confidence: 99%

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

Kim

Park

Kim

et al. 2018

J Minim Invasive Surg

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Purpose: Laparoscopic adhesiolysis is increasingly used to treat patients with small bowel obstruction (SBO), however, its safety of laparoscopic surgery(LS) with bowel resection in SBO is unclear. The purpose of the present study was to compare the perioperative outcomes of LS with those of open surgery (OS) for SBO and to evaluate the risk factors of 30-day postoperative morbidity and recurrence. Methods:We retrospectively reviewed medical records of patients who had been diagnosed with SBO and underwent surgery at four Hallym-University-affiliated hospitals between January 2013 and December 2016. The rates of 30-day postoperative complications and recurrence were compared between groups using univariate and multivariate analysis. Propensity score matching was performed to compare the outcome.Results: A total of 117 patients with SBO were included in the present study, of which 86 underwent OS and 31 underwent LS. Time to water intake, time to soft diet, and postoperative hospital stay were significantly shorter in the LS group (p=0.002, 0.003, and 0.027, respectively). The complication (p=0.249) and recurrence rate (p=0.679) were similar between the two group. Propensity score matching analysis demonstrated that laparoscopic surgery showed quicker recovery and similar complication and recurrence rate. In multivariate analysis, LS was not associated with either complications (p=0.806) or recurrence (p=0.956). Conclusion:LS is associated with several perioperative advantages for the treatment of SBO without affecting the risk of 30-day postoperative complications or recurrence. Therefore LS can be a safe and feasible option for treating SBO.

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“…Maintain strict compliance with the aseptic concept. Upholding and strengthening the aseptic operation can maximally prevent bacteria from infecting the incisions; it can also reduce iatrogenic infection and resolve the infection caused by intestinal adhesion formation [19]. 2.…”

Section: Discussionmentioning

confidence: 99%

Clinical Treatment and Analysis of Laparoscopic Enterolysis Surgery

Baoyin¹,

Yan

et al. 2013

Indian J Surg

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This work aims to explore the application value and clinical efficacy of laparoscopic enterolysis surgery for the treatment of adhesive intestinal obstruction. A total of 126 inpatient cases of intestinal adhesion were selected. In order to observe the effects and complications of surgery, the patients were randomly assigned into laparoscopic and laparotomy groups, with 63 cases in each group. The operative time, blood loss, postoperative ambulation time, exhaustion time, postoperative analgesia number of patients, and hospital days of the patients in the laparoscopic group were compared with those in the control group, and the differences were all statistically significant (p <0.05). In the laparoscopy group, two patients experienced rupture of the small intestine during the surgery, but recovered well after endoscopic suture repair, although there was one case of postoperative pulmonary infection. The difference was statistically significant in the laparotomy group of patients, with one case of intestinal fistula, two cases of surgical wound infection, one case of incisional hernia, three cases of postoperative pulmonary infection, and one case of urinary tract infection. Compared with laparotomy, laparoscopic enterolysis surgery has shorter operative time, less blood loss, faster postoperative recovery, and fewer complications.

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Nationwide Impact of Laparoscopic Lysis of Adhesions in the Management of Intestinal Obstruction in the US

Cited by 62 publications

References 16 publications

Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Safety and Feasibility of Laparoscopic Surgery for Small Bowel Obstruction

Clinical Treatment and Analysis of Laparoscopic Enterolysis Surgery

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