The experience of using video laparoscopy in the examination and treatment of patients with acute small bowel obstruction
Abstract
Background. For many decades, the issues of diagnosis and treatment of acute bowel obstruction have not lost importance, but an analysis of the available scholarly publications on endoscopic diagnosis and treatment of adhesive small bowel obstruction shows that the experience of using these techniques is limited, and many aspects of them are currently under study and discussion. Aim of this study – to demonstrate the effectiveness of using video laparoscopy when diagnosing and treating acute adhesive small bowel obstruction.
Material and methods. The design of the study is retrospective; the level of evidence is II. 340 patients with acute small bowel obstruction were operated on after conservative treatment was proved ineffective. Out of them, 72 patients with acute intestinal obstruction were treated using video laparoscopy.
Results. Laparoscopic adhesiolysis for emergency indications for surgery is technically feasible; however, it requires a careful selection of patients and a special training for medical staff. The most common cause of acute small bowel obstruction was an adhesion process, found in 55.6% (n=189), while the most rare cause was small bowel obstruction caused by a gallstone observed in 7.9% (n=27). 7 (2%) people needed conversion. There were no deaths, no complications, and no relapses. On average, patients who underwent endoscopic surgery were discharged after 5 hospital days.
Conclusion. Video endoscopic surgery allows to effectively identify and eliminate the cause of acute adhesive small bowel obstruction while minimizing the likelihood of relapse. The use of video technologies in endoscopic surgery helps to avoid unneeded laparotomies, reducing the time needed for dynamic observation and inpatient treatment, which will result in increased cost-effectiveness.
Keywords:acute small bowel obstruction, adhesions, laparoscopy, video endoscopic surgery
Conflict of interest. The authors declare no conflict of interest.
For citation: Turbin M.V., Cherkasov M.F., Ustimenko I.V., Krasenkov Yu.V., Melikova S.G. The experience of using video laparoscopy in the examination and treatment of patients with acute small bowel obstruction. Clin Experiment Surg. Petrovsky J. 2020; 8 (2): 67–72. DOI: 10.33029/2308-1198-2020-8-2-67-72 (in Russian)
Received 07.11.2019. Accepted 26.03.2020.
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