Laparoscopic versus open adhesiolysis in patients with small bowel obstruction: a single-center retrospective study
EAES Academy. Lovitskyi Y. 07/05/22; 363088; P133
Ms. Yurii Lovitskyi
Contributions
Contributions
Abstract
Background:
Laparoscopic adhesiolysis is an alternative for open surgery in an adhesive small bowel obstruction. Despite a large amount of retrospective and prospective studies, there is still a gap in understanding of how it works in a private hospital in Ukraine.
Methods:
We analyzed the prospective database to determine the immediate surgical outcomes of the 52 patients, operated because of adhesive small-bowel obstruction in a private hospital in Kyiv, Ukraine, between January 2019 and May 2021. The main objects were to evaluate 30 days postoperative morbidity, mortality and readmission rates, length of hospital stay, pain control, operative time.
Results:
A total of 23 patients underwent laparoscopic adhesiolysis and 29 patients had surgeries performed by open approach. Laparoscopic group of patients was accurately selected: younger, had fewer previous abdominal operations, and by enhanced computed tomography of abdomen less adhesions were suggested. The mean operative time for laparoscopic procedures was substantially less than for open (56,80±25,02 min vs. 134,69±67,51 min). Postoperative hospital stay (4,00±1,21 days vs. 7,13±3,33 days, p=0.041) was found to be shorter in laparoscopic group. Patients after laparoscopic procedure experienced significantly less pain on the 1st postoperative day (mean VAS-score was 2.4 vs 6.1). Severe complications` rate (Clavien-Dindo 3A or higher) was 0% in the laparoscopic group versus 13.79 % in the open approach group. There were not readmissions found in any of groups. There was no death in both groups during the 30 days follow up.
Conclusions:
In highly selected patients laparoscopic approach for management of adhesive small-bowel obstruction appeared to be safe and feasible.
Laparoscopic adhesiolysis is an alternative for open surgery in an adhesive small bowel obstruction. Despite a large amount of retrospective and prospective studies, there is still a gap in understanding of how it works in a private hospital in Ukraine.
Methods:
We analyzed the prospective database to determine the immediate surgical outcomes of the 52 patients, operated because of adhesive small-bowel obstruction in a private hospital in Kyiv, Ukraine, between January 2019 and May 2021. The main objects were to evaluate 30 days postoperative morbidity, mortality and readmission rates, length of hospital stay, pain control, operative time.
Results:
A total of 23 patients underwent laparoscopic adhesiolysis and 29 patients had surgeries performed by open approach. Laparoscopic group of patients was accurately selected: younger, had fewer previous abdominal operations, and by enhanced computed tomography of abdomen less adhesions were suggested. The mean operative time for laparoscopic procedures was substantially less than for open (56,80±25,02 min vs. 134,69±67,51 min). Postoperative hospital stay (4,00±1,21 days vs. 7,13±3,33 days, p=0.041) was found to be shorter in laparoscopic group. Patients after laparoscopic procedure experienced significantly less pain on the 1st postoperative day (mean VAS-score was 2.4 vs 6.1). Severe complications` rate (Clavien-Dindo 3A or higher) was 0% in the laparoscopic group versus 13.79 % in the open approach group. There were not readmissions found in any of groups. There was no death in both groups during the 30 days follow up.
Conclusions:
In highly selected patients laparoscopic approach for management of adhesive small-bowel obstruction appeared to be safe and feasible.
Background:
Laparoscopic adhesiolysis is an alternative for open surgery in an adhesive small bowel obstruction. Despite a large amount of retrospective and prospective studies, there is still a gap in understanding of how it works in a private hospital in Ukraine.
Methods:
We analyzed the prospective database to determine the immediate surgical outcomes of the 52 patients, operated because of adhesive small-bowel obstruction in a private hospital in Kyiv, Ukraine, between January 2019 and May 2021. The main objects were to evaluate 30 days postoperative morbidity, mortality and readmission rates, length of hospital stay, pain control, operative time.
Results:
A total of 23 patients underwent laparoscopic adhesiolysis and 29 patients had surgeries performed by open approach. Laparoscopic group of patients was accurately selected: younger, had fewer previous abdominal operations, and by enhanced computed tomography of abdomen less adhesions were suggested. The mean operative time for laparoscopic procedures was substantially less than for open (56,80±25,02 min vs. 134,69±67,51 min). Postoperative hospital stay (4,00±1,21 days vs. 7,13±3,33 days, p=0.041) was found to be shorter in laparoscopic group. Patients after laparoscopic procedure experienced significantly less pain on the 1st postoperative day (mean VAS-score was 2.4 vs 6.1). Severe complications` rate (Clavien-Dindo 3A or higher) was 0% in the laparoscopic group versus 13.79 % in the open approach group. There were not readmissions found in any of groups. There was no death in both groups during the 30 days follow up.
Conclusions:
In highly selected patients laparoscopic approach for management of adhesive small-bowel obstruction appeared to be safe and feasible.
Laparoscopic adhesiolysis is an alternative for open surgery in an adhesive small bowel obstruction. Despite a large amount of retrospective and prospective studies, there is still a gap in understanding of how it works in a private hospital in Ukraine.
Methods:
We analyzed the prospective database to determine the immediate surgical outcomes of the 52 patients, operated because of adhesive small-bowel obstruction in a private hospital in Kyiv, Ukraine, between January 2019 and May 2021. The main objects were to evaluate 30 days postoperative morbidity, mortality and readmission rates, length of hospital stay, pain control, operative time.
Results:
A total of 23 patients underwent laparoscopic adhesiolysis and 29 patients had surgeries performed by open approach. Laparoscopic group of patients was accurately selected: younger, had fewer previous abdominal operations, and by enhanced computed tomography of abdomen less adhesions were suggested. The mean operative time for laparoscopic procedures was substantially less than for open (56,80±25,02 min vs. 134,69±67,51 min). Postoperative hospital stay (4,00±1,21 days vs. 7,13±3,33 days, p=0.041) was found to be shorter in laparoscopic group. Patients after laparoscopic procedure experienced significantly less pain on the 1st postoperative day (mean VAS-score was 2.4 vs 6.1). Severe complications` rate (Clavien-Dindo 3A or higher) was 0% in the laparoscopic group versus 13.79 % in the open approach group. There were not readmissions found in any of groups. There was no death in both groups during the 30 days follow up.
Conclusions:
In highly selected patients laparoscopic approach for management of adhesive small-bowel obstruction appeared to be safe and feasible.
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