腹腔镜治疗单条粘连带所致小肠梗阻
Laparoscopy for Small Bowel Obstruction Caused by Single Adhesive Band.
作者信息
Suh Suk Won, Choi Yoo Shin
机构信息
Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.
出版信息
JSLS. 2016 Jul-Sep;20(3). doi: 10.4293/JSLS.2016.00048.
BACKGROUND AND OBJECTIVES
There are still concerns about the comparative outcomes of operative treatment (OT) and conservative (nonsurgical) treatment (CT) for small bowel obstruction (SBO), especially that caused by single adhesive bands. We performed a retrospective study to compare surgical with nonsurgical outcomes.
METHODS
A total of 62 patients were enrolled. The OT group underwent laparoscopy (n = 16), and the CT group (n = 46) did not. We compared early and late outcomes between the 2 groups.
RESULTS
Times to first flatus, oral intake, and defecation after treatment were shorter in the OT group (P = .030, .033, and .024), and the recurrence rate was lower in the OT group than in the CT group (6.2% vs 32.6%; P = .038). Time from discharge to first recurrence was longer in the OT group than in the CT group (172 vs 104.6 ± 26.5 days, P = .027).
CONCLUSIONS
SBO related to a single adhesive band is not effectively treated by CT. However, laparoscopic OT provides notable success if the surgery is performed early. Therefore, it should be the preferred treatment.
背景与目的
对于小肠梗阻（SBO），尤其是由单一粘连带引起的小肠梗阻，手术治疗（OT）与保守（非手术）治疗（CT）的比较结果仍存在争议。我们进行了一项回顾性研究，以比较手术治疗与非手术治疗的结果。
方法
共纳入62例患者。OT组接受了腹腔镜检查（n = 16），CT组（n = 46）未接受。我们比较了两组的早期和晚期结果。
结果
OT组治疗后首次排气、经口进食和排便的时间较短（P = 0.030、0.033和0.024），OT组的复发率低于CT组（6.2%对32.6%；P = 0.038）。OT组从出院到首次复发的时间比CT组长（172天对104.6±26.5天，P = 0.027）。
结论
CT不能有效治疗与单一粘连带相关的SBO。然而，如果早期进行手术，腹腔镜OT会取得显著成功。因此，它应成为首选治疗方法。
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