François Y, Mouret P, Vignal J
Service de Chirurgie Générale et Digestive, Hôpital Claude-Bernard, Oullins.
Ann Chir. 1994;48(2):165-8.
The authors treated 16 patients with small bowel obstruction by 19 laparoscopy (3 patients underwent 2 laparoscopies). The operation was performed 4 times as an emergency and in 15 cases after resolution of the obstruction in patients who had already experienced such attacks. Adhesiolysis was complete in 14 cases and incomplete in 5 cases. Conversion in laparotomy was necessary in one patient to cure a total obstruction. 2 operative complications were reported (bowel perforation during enterolysis); one of which required conversion into laparotomy). This patient also developed post-operative complications whereas the post-operative course was uneventful for the other patients. Five patients developed an obstructive recurrence which required laparotomy in 2 cases and laparoscopy in the other 3 cases; but for two patients, initial enterolysis had been incomplete and a laparotomy was performed on another patient. Laparoscopic viscerolysis seems to be attractive but, the long-term outcome, and the frequency of adhesion recurrence need to be defined.
作者对16例小肠梗阻患者进行了19次腹腔镜手术（3例患者接受了2次腹腔镜手术）。该手术4次作为急诊进行，15次是在已经经历过此类发作的患者梗阻解除后进行。14例粘连松解完全，5例不完全。1例患者需要转为开腹手术以治疗完全性梗阻。报告了2例手术并发症（肠粘连松解术中肠穿孔）；其中1例需要转为开腹手术。该患者还出现了术后并发症，而其他患者术后过程平稳。5例患者出现梗阻复发，其中2例需要开腹手术，另外3例需要腹腔镜手术；但有2例患者最初的肠粘连松解不完全，另一例患者进行了开腹手术。腹腔镜内脏松解术似乎很有吸引力，但长期效果以及粘连复发的频率仍需明确。
