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Langenbeck's Archives of Surgery

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01-01-2010 | Original Article

Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Authors: Franziska Carmen Grafen, Valentin Neuhaus, Othmar Schöb, Matthias Turina

Published in: Langenbeck's Archives of Surgery | Issue 1/2010

Abstract

Purpose

The aim of this study is to compare the results of laparoscopic management of acute small bowel obstruction (SBO) from abdominal adhesions to both exploratory laparotomy and secondary conversion to open surgery.

Materials and methods

Ninety-three patients (mean age 61 years) with adhesion-induced SBO were divided into successful laparoscopy (66 patients [71%]), secondary conversion (24 [26%]), and primary laparotomy (three patients).

Results

Patients with successful laparoscopy had more simple adhesions (57%), fewer prior operations, and lower American Society of Anesthesiologists (ASA) class. Operative time was shortest in the laparoscopy group (74.3 ± 4.4 min), as was the duration of both intensive care unit and hospital stay. Mortality was 6%, regardless of operative technique.

Conclusions

A trial of laparoscopic adhesiolysis by a surgeon with advanced laparoscopic skills seems advisable in the majority of patients with acute adhesive SBO, whereas patients with more extensive adhesions, higher ASA class, and more than two prior abdominal operations often require laparotomy to achieve equally satisfactory outcome.

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Title: Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital
Authors: Franziska Carmen Grafen
Valentin Neuhaus
Othmar Schöb
Matthias Turina
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 1/2010
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-009-0490-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of acute small bowel obstruction from intestinal adhesions: indications for laparoscopic surgery in a community teaching hospital

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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