Fortea-Sanchis C, Priego-Jiménez P, Martínez-Ramos D, Ángel-Yepes V, Villegas-Cánovas C, Escrig-Sos J, Salvador-Sanchis J L
Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, España.
Servicio de Cirugía General y Digestiva, Hospital General de Castellón, Castellón, España.
Rev Gastroenterol Mex. 2013 Oct-Dec;78(4):219-24. doi: 10.1016/j.rgmx.2013.07.006. Epub 2013 Nov 28.
The laparoscopic approach to bowel obstruction is still controversial.
To evaluate our initial results in the laparoscopic treatment of bowel obstruction.
A retrospective study on patients diagnosed with bowel obstruction that underwent laparoscopic surgery within the time frame of January 2008 to June 30, 2012. The variables employed were: age, sex, occlusion etiology, previous surgeries, clinical progression, pneumoperitoneum creation, use of an auxiliary incision, anesthesia duration, conversion rate, postoperative hospital stay, time needed to tolerate liquids, and complications.
Twenty-six patients, 18 women (69.2%) and 8 men (30.8%), with a mean age of 64.35 years (range: 21-92 years) were analyzed. The most frequent obstruction etiology was secondary to adhesions and presented in 12 cases. Nine patients (34.6%) underwent a completely laparoscopic approach and laparoscopy was complemented by an auxiliary incision in another 9 patients (34.6%), resulting in 18 cases (69.2%) of successful laparoscopic approach. Eight patients (30.8%) required conversion to open surgery. The mean anesthesia duration was 95min (range: 55-165min), mean postoperative hospital stay was 6 days (range: 3-72 days), and the mean amount of time needed to tolerate liquids was 3 days (range: 1-10 days). The patients that underwent complete laparoscopic approach presented with shorter hospital stay, they were able to ingest liquids earlier, and they presented with a lower number of postoperative complications; this latter variable was the only one that was statistically significant.
The initial results of our experience were good, although more patients are needed in order to standardize and extend the use of this technique.
腹腔镜治疗肠梗阻仍存在争议。
评估我们在腹腔镜治疗肠梗阻方面的初步结果。
对2008年1月至2012年6月30日期间诊断为肠梗阻并接受腹腔镜手术的患者进行回顾性研究。所采用的变量包括：年龄、性别、梗阻病因、既往手术史、临床进展、气腹形成、辅助切口的使用、麻醉持续时间、中转率、术后住院时间、耐受液体所需时间以及并发症。
分析了26例患者，其中18例女性（69.2%），8例男性（30.8%），平均年龄64.35岁（范围：21 - 92岁）。最常见的梗阻病因是粘连，共12例。9例患者（34.6%）采用完全腹腔镜手术方式，另外9例患者（34.6%）腹腔镜手术辅以辅助切口，18例（69.2%）成功完成腹腔镜手术。8例患者（30.8%）需要中转开腹手术。平均麻醉持续时间为95分钟（范围：55 - 165分钟），平均术后住院时间为6天（范围：3 - 72天），耐受液体所需平均时间为3天（范围：1 - 10天）。采用完全腹腔镜手术方式的患者住院时间较短，能更早摄入液体，术后并发症数量较少；后一变量是唯一具有统计学意义的变量。
我们的初步经验结果良好，尽管需要更多患者来规范和推广该技术的应用。
