Okamoto H, Wakana H, Kawashima K, Fukasawa T, Fujii H
Department of Surgery, Tsuru Municipal Hospital, Yamanashi, Japan.
Asian J Endosc Surg. 2012 May;5(2):53-8. doi: 10.1111/j.1758-5910.2011.00117.x. Epub 2011 Nov 24.
Laparoscopy for small bowel obstruction (SBO) has increasingly been performed for the advantages minimally invasive surgery provides. However, its benefit remains unclear.
From January 2004 to July 2011, we enrolled 28 consecutive patients who underwent a laparoscopic operation for SBO, secondary to postoperative adhesions. We compared the results of SBO patients treated laparoscopically with those of 25 patients who underwent conventional open laparotomy in a retrospective matched-pair analysis.
Laparoscopic treatment was completed in 25 patients (89%), including 17 laparoscopic-assisted cases. The mean procedural time was 112 minutes in the laparoscopic group and 79 minutes in the open group (P < 0.05). Patients resumed oral intake after a mean of 3 days in the laparoscopic group compared with a mean of 6.5 days in the open group (P < 0.05). The length of hospital stay was 11 and 22 days (P < 0.05), respectively, in the laparoscopic and open groups. Postoperative complications occurred in two patients in the laparoscopy group and 14 patients in the open group (P < 0.05).
The laparoscopic approach was effective for the management of mechanical SBO in selected patients. Furthermore, minimally invasive laparoscopic adhesiolysis is also feasible and brings the benefit of cosmetic results.
由于微创手术具有诸多优势，腹腔镜治疗小肠梗阻（SBO）的应用越来越广泛。然而，其疗效仍不明确。
从2004年1月至2011年7月，我们纳入了28例因术后粘连继发SBO而接受腹腔镜手术的连续患者。在一项回顾性配对分析中，我们将腹腔镜治疗SBO患者的结果与25例行传统开腹手术的患者进行了比较。
25例患者（89%）完成了腹腔镜治疗，其中包括17例腹腔镜辅助病例。腹腔镜组的平均手术时间为112分钟，开腹组为79分钟（P<0.05）。腹腔镜组患者平均在3天后恢复经口进食，而开腹组平均为6.5天（P<[0.05）。腹腔镜组和开腹组的住院时间分别为11天和22天（P<0.05）。腹腔镜组有2例患者发生术后并发症，开腹组有14例患者发生术后并发症（P<0.05）。
腹腔镜手术方法对特定患者的机械性SBO治疗有效。此外，微创腹腔镜粘连松解术也是可行的，并带来了美观的效果。
