Clinical application of laparoscopic lysis of adhesions in adhesive intestinal obstruction / 中国内镜杂志

ABSTRACT

Objective To evaluate the clinical efficacy and safety of laparoscopic adhesiolysis for patients with adhesive ileus. Methods Clinical data and follow-up data of 95 cases of adhesive ileus were retrospectively analyzed. Based on the surgical approach, patients were divided into laparotomy group (43 cases) and laparoscopic group (52 cases), and the intraoperative situation postoperative complications and recurrence were compared. Results The operation time of laparoscopy group was less than the laparotomy group [(68.35 ± 36.47) vs (82.54 ± 23.27) min, t = 2.21, P = 0.029]; blood loss was less than the laparotomy group [(69.51 ± 20.33) vs (198.37 ± 50.04) ml, t = 16.97, P = 0.000]; postoperative analgesic dosage was less than the laparotomy group [(1.01 ± 0.99) vs (3.46 ± 1.53), t = 9.41, P = 0.000]; time of posterior ambulation was less than the laparotomy group [(11.05 ± 1.32) vs (20.36 ± 2.59) d, t = 16.97, P = 0.000]; gastrointestinal function recovery time was less than laparotomy group [(2.30 ± 1.38) vs (4.05 ± 1.74) d, t = 5.47, P = 0.000]; catheter removal time was lower than the laparotomy group [(3.04 ± 2.11) vs (5.36 ± 2.24) d, t = 5.19, P = 0.000]; hospital stay was less than the laparotomy group [(5.89 ± 1.57) vs (10.36 ± 2.65) d, t = 10.02, P = 0.000]; the postoperative complication rate of laparoscopy group and laparotomy group was 3.84% (2 cases) and 16.27% (7 cases), respectively, the difference was not statistically significance (χ2 = 4.24, P = 0.074); followed up from 8 to 36 months, there were 2 cases, 6 cases of intractable abdominal pain and intestinal obstruction recurrence in laparoscopy group and laparotomy group respectively, the relapse outcomes of laparotomy group was higher than laparoscopy group, but the difference was not statistically significant (χ2 = 3.64, P = 0.056). Conclusion Laparoscopic adhesiolysis is safe, effective, and have the characteristics with less trauma, less interference on the abdominal cavity, it is better than open surgery.