Tazeoğlu Deniz, Benli Sami, Tikici Deniz, Esmer Ahmet Cem, Dirlik Mustafa Musa
Department of General Surgery, Faculty of Medicine Mersin University, Mersin, Turkey.
Pol Przegl Chir. 2022 Feb 11;94(5):23-30. doi: 10.5604/01.3001.0015.7342.
<br><b>Introduction:</b> Postoperative intra-abdominal adhesions are a clinical condition that may develop after any abdominal surgery and constitute the leading cause of mechanical small bowel obstructions.</br> <br><b>Aim:</b> This study investigates factors which influence the formation of postoperative adhesion and evaluates the efficiency of applying minimally invasive surgical techniques in reducing adhesion.</br> <br><b>Material and methods:</b> Patients who underwent surgery to diagnose obstructive ileus in our clinic between January 2015 and January 2020 were analyzed retrospectively. Demographic data of the patients, operation details time between the operations and history of hospitalizations, postoperative mortality and morbidity, as well as the severity of complications were recorded. The patients included in the study were divided into groups according to the surgical technique applied in the first operation (laparoscopy/ laparotomy), the abdominal incision line (upper/lower/total), and the etiology of the primarily operated lesion (benign/malignant).</br> <br><b>Results:</b> One hundred eighteen (118) patients were included in the study. The mean age of patients was 61.2 ± 10.8 (39-82) years. Age, ileus history, time to the onset of ileus, length of hospital stay and the number of complications were shorter in the laparoscopy group as compared to the laparotomy group and the difference was found to be statistically significant. In addition, when patients were categorized according to the abdominal incision line, fewer hospitalizations and more frequent postoperative complications due to ileus were observed in the sub-umbilical incision group (p < 0.05).</br> <br><b>Conclusions:</b> Postoperative adhesion formation is currently one of the clinical conditions which pose a challenge to both the patient and the clinician due to its incidence and recurrence. However, adhesion formation can be reduced by applying minimally invasive surgical methods, especially laparoscopic surgery and precise maneuvers during surgery.</br>.
引言:术后腹腔粘连是一种可能在任何腹部手术后出现的临床状况,是机械性小肠梗阻的主要原因。
目的:本研究调查影响术后粘连形成的因素,并评估应用微创手术技术减少粘连的效果。
材料与方法:对2015年1月至2020年1月期间在我院接受手术以诊断肠梗阻的患者进行回顾性分析。记录患者的人口统计学数据、手术细节、手术间隔时间和住院史、术后死亡率和发病率以及并发症的严重程度。根据首次手术应用的手术技术(腹腔镜手术/开腹手术)、腹部切口线(上/下/全)以及初次手术病变的病因(良性/恶性)将纳入研究的患者分组。
结果:118例患者纳入本研究。患者的平均年龄为61.2±10.8(39 - 82)岁。与开腹手术组相比,腹腔镜手术组患者的年龄、肠梗阻病史、肠梗阻发病时间、住院时间和并发症数量均较短,差异具有统计学意义。此外,根据腹部切口线对患者进行分类时,脐下切口组的住院次数较少,但因肠梗阻导致的术后并发症更频繁(p<0.05)。
结论:由于术后粘连形成的发生率和复发率,它目前是给患者和临床医生都带来挑战的临床状况之一。然而,通过应用微创手术方法,尤其是腹腔镜手术和手术中的精确操作,可以减少粘连形成。