Yozo Suzuki, MD, PhD, Mitsuyoshi Tei, MD, PhD, Ohtsuka Masahisa, MD, PhD, Kenta Furukawa, MD, PhD, Toru Masuzawa, MD, PhD, Kentaro Kishi, MD, PhD, Masayuki Tori, MD, PhD, Masahiro Tanemura, MD, PhD, Hiroki Akamatsu, MD, PhD. Osaka Poice Hospital
BACKGROUND: Ileus has a variety of backgrounds and its operation mode is often modified to meet the intraoperative requirements. Single incision laparoscopic surgery (SILS) is a laparoscopic procedure which leaves a single small incision in navel, and has been reported to be less invasive than and as safe and efficient as the conventional multiport laparoscopic surgery (MPS). The role of SILS in the ileus operation has not been well studied.
OBJECTIVE: The aim of this study was to examine the perioperative outcome of SILS in ileus operation.
METHODS: This is a retrospective study from a prospectively collected database. The investigation took place in a high-volume mutidiciplinary acute hospital in Japan. From 2011 to 2015, 64 consecutive patients who were treated for non-cancerous ileus were identified.
RESULTS: Out of 64 non-cancerous ileus patients, 43 patients were planned for open surgery (OS) (4; unstable vital signs, 3; ischemic change suspected, 5; post-perforation operation, 31; severe distension) and 21 were planned for SILS. The background of patients who had SILS was as follows; median age was 66 (20-88) year-old, 13 (61.9%) were female, 17 (81.1%) were Performance Status 0 or 1, Preoperative diagnosis was adhesion in 10 (47.6%) and strangulation in 11 (52.4%), the first ileus episode in 15 (71.4%), the number of past abdominal operative history was 0 in 5 (23.8%) and one in 14 (66.7%). Operation mode was as follows; small bowel resection in 8 (38.1%), derotation in 6(28.6%), adhesiolysis in 4(19.0%), debanding in 2(9.5%), colectomy in 1(3.8%). Perioperative outcome was as follows; the median operation time was 121 (38-217) min, bleeding Volume was 0 (0-500mL), being completed by SILS in 15 (71.5%) and converted to OS in 6(18.5%) (3; unable to detect responsible lesions, 2; difficult to perform procedure, 1; broad necrosis of intestine detected), intraoperative damage to organ occurred in 2 (serosal damage due to adhesiolysis), surgical site infection occurred in 2 (9.5%), pneumonia occurred in 1 (4.7%). Median hospital stay after surgery was 11 (5-35) days.
CONCLUSIONS: SILS in selected patients is a reasonable option in ileus surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80687
Program Number: P600
Presentation Session: Poster (Non CME)
Presentation Type: Poster