Nordin Ann, Freedman Jacob
Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
Surg Endosc. 2016 Oct;30(10):4454-63. doi: 10.1007/s00464-016-4776-2. Epub 2016 Feb 29.
Laparotomy is the standard surgical approach for treatment of small bowel obstruction (SBO). Laparoscopic management could be beneficial in terms of less complications and shorter hospital stay. As the minimal invasive approach is gaining more acceptances in the treatment of SBO, there is an increased need of studies to analyze outcomes. The aim of the present study was to compare the short-term clinical outcomes of laparoscopy versus laparotomy in the surgical management of non-bariatric, non-malignant SBO.
A retrospective analysis of patients treated for SBO during 2010-2015 was made by a comprehensive search of medical records. A matched-pair review was performed on patients managed surgically for non-bariatric, non-malignant SBO at Danderyd University Hospital, Stockholm, Sweden. Completed laparoscopic surgeries were matched against patients treated with open surgery.
Laparoscopy for SBO was initiated in 71 patients. Conversion to open surgery was performed in 42 %. Results from the matched-pair analysis showed that post-operative length of stay was reduced by 60 % (P < 0.001) in the laparoscopic cohort. Additionally, less major complications were reported and duration of surgery was reduced by 50 % (P < 0.001).
Laparoscopic management is a safe and feasible alternative to laparotomy. Hospital length of stay was significantly shorter and morbidity rate acceptable.
剖腹手术是治疗小肠梗阻（SBO）的标准手术方法。腹腔镜手术在减少并发症和缩短住院时间方面可能具有优势。随着微创方法在SBO治疗中越来越被接受，对分析其治疗效果的研究需求也日益增加。本研究的目的是比较腹腔镜手术与剖腹手术在非肥胖、非恶性SBO手术治疗中的短期临床效果。
通过全面检索病历，对2010年至2015年期间接受SBO治疗的患者进行回顾性分析。对瑞典斯德哥尔摩丹德吕德大学医院接受手术治疗的非肥胖、非恶性SBO患者进行配对回顾。将完成的腹腔镜手术患者与接受开放手术的患者进行配对。
71例患者开始接受腹腔镜SBO手术。42%的患者转为开放手术。配对分析结果显示，腹腔镜组患者术后住院时间缩短了60%（P < 0.001）。此外，报告的严重并发症较少，手术时间缩短了50%（P < 0.001）。
腹腔镜手术是剖腹手术的一种安全可行的替代方法。住院时间显著缩短，发病率可接受。
