Cirocchi R, Giustozzi G, De Sol A, Bravetti M, Cattorini L, Del Monaco P, Migliaccio C, Sciannameo F
Clinica Chirurgica Generale e d'Urgenza, Azienda Ospedaliera di Terni, Università degli Studi di Perugia, Perugia.
Minerva Chir. 2007 Dec;62(6):477-88.
At the beginning of the laparoscopic surgery, intestinal obstruction was considered an absolute contraindication for this approach, because of the high risk of injuring the bowel. Today laparoscopic surgery for small bowel obstruction is still under evaluation. Adhesions are the most common cause of obstruction; although an important proportion of these patients can be nonoperatively treated, some of these require immediate operation. The aim of this review was to evaluate the reliability and immediate results of laparoscopic management of small bowel obstruction by postoperative adhesions. Laparoscopic management of acute small bowel obstruction is feasible, but it is often difficult and may be hazardous. The patients with acute obstruction may be undergo laparoscopy after a careful selection. Morbidity is low if the operation is performed by skilled. The immediate benefit is rapid intestinal motility and shorter hospital stay. The long-term effect is the prevention of small bowel obstruction recurrences by new postoperative adhesions.
在腹腔镜手术开展初期,肠梗阻被视为这种手术方式的绝对禁忌证,因为存在损伤肠管的高风险。如今,腹腔镜治疗小肠梗阻仍在评估之中。粘连是梗阻最常见的原因;尽管这些患者中有很大一部分可以进行非手术治疗,但其中一些患者仍需要立即手术。本综述的目的是评估腹腔镜处理术后粘连所致小肠梗阻的可靠性及近期疗效。腹腔镜处理急性小肠梗阻是可行的,但操作往往困难且可能存在风险。急性肠梗阻患者经仔细筛选后可接受腹腔镜检查。若由技术熟练的医生进行手术,并发症发生率较低。近期益处是肠道蠕动恢复快且住院时间缩短。长期效果是预防因新的术后粘连导致的小肠梗阻复发。