Retrospective Analysis of Laparoscopic Approach in Intestinal Obstruction

Masaru Matsumura, MD, Tomoaki Okada, MD, Yoshitomo Ueno, MD, Kei Tamura, MD, Tetsuya Mizumoto, MD, Naoki Ishida, MD, Yoshinori Imai, MD, Taro Nakamura, MD, Hidenori Kiyochi, MD, Kenzo Okada, MD, Toshihiko Sakao, MD, Shinsuke Kajiwara, MD. Uwajima city hospital

INTRODUCTION
Laparoscopic approach for intestinal obstruction is controversial because of obstacles including dilated loops of bowel, a limited working space and postoperative adhesion. The aim of this retrospective study was to verify the benefit of laparoscopic approach for intestinal obstruction.

METHODS AND PROCEDURES
Surgical treatment for intestinal obstruction was undertaken in 40 cases between January 2010 and September 2011 at our department. These consisted of 23 open approach cases (OA) and 17 laparoscopic approach cases (LA). We accessed these outcomes and compared LA with OA.

RESULTS
LA resulted in fewer blood loss (58±35.5 g for LA versus 228±85.0 g for OA mean, p=0.03) and earlier oral intake(2.3±0.25days for LA versus 3.7±0.51 days for OA mean, p=0.02).There was a trend toward a shorter operating time in LA(84±12.7min for LA versus 96±9.6min for OA mean, p=0.02).Postoperative complications within 30-days included 6 patients in OA (5 surgical site infections and 1 aspiration pneumonia) and no patient in LA.OA included 1 death due to aspiration pneumonia. One recurrence was found in OA and 2 recurrences were found in LA.

CONCLUSIONS
It suggests that laparoscopic approach for intestinal obstruction is less invasive and results in fewer complications than open approach. A relatively high recurrence rate was observed in laparoscopic approach cases.
 

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