[Laparoscopic adhesiolysis in the treatment of acute adhesive obstruction of the small intestine].

The results of operative treatment of 59 patients, suffering an acute adhesive ileus of small intestine (ISI), are presented. In 28 patients obturation ileus was diagnosed intraoperatively and in 31 - the strangulation one. In 14 patients an early postoperative adhesive ISI was noted. In all of them diagnostic laparoscopy was used. In 45 patients ISI was eliminated, using laparoscopic method, in 14--the conversion was performed, including the small intestine resection in 8 of them. One patient died (lethality 1.7%). In one patient the adhesive ISI recurrence have occurred in 8 months after laparoscopic adhesiolysis performance. Minimal trauma, short duration of the operation, good cosmetic results, uncomplicated course of postoperative period witnesses the efficacy of laparoscopic adhesiolysis in the treatment of an acute adhesive ISI.

[Treatment of early postoperative adhesive small bowel obstruction].

The results of treatment of 22 patients (12 men, 10 women) with acute early postoperative adhesive small bowel obstruction are presented. Obturation was detected in 16, strangulation - in 6 cases. In 12 patients obstruction was solved laparoscopically, in 8 patients laparotomy was performed, in two cases conversion was done. In 4 patients resection of the small intestine was done, in two instances terminal enterostomy was made. The average period passed from the previous operation till the intervention for bowel obstruction was 11,1 ± 8,0 (2-30) days. In the laparotomy group the following complications were observed: enteric fistulas - 1 patient, subcutaneous eventration - 1 patient. There was no mortality. During the period of observation no recurrence of intestinal obstruction was observed. Laparoscopic adhesiolysis provides minimal trauma, which is especially important in the early postoperative period.