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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2020
vol. 15
 
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abstract:
Original paper

Evaluation of laparoscopic surgery for small bowel obstruction and factors related to outcomes

Hajime Kayano
1
,
Eiji Nomura
1
,
Yasuhiko Ueda
1
,
Toru Kuramoto
2
,
Takashi Machida
1
,
Shuji Uda
1
,
Masaya Mukai
1
,
Seiichiro Yamamoto
3
,
Hiroyasu Makuuchi
1

  1. Department of General and Gastroenterological Surgery, Tokai University Hachioji Hospital, Tokyo, Japan
  2. Department of General and Gastroenterological Surgery, Saiseikai Suita Hospital, Osaka, Japan
  3. Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
Videosurgery Miniinv 2020; 15 (2): 268–275
DOI: https://doi.org/10.5114/wiitm.2020.93243
Online publish date: 2020/02/24
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Introduction
In recent years, laparoscopic surgery (LS) has been performed for small bowel obstruction (SBO). However, the indications and short-term and long-term outcomes of LS for SBO have not yet been established.

Aim
To evaluate the usefulness of LS for SBO compared to open surgery (OS), as well as to identify risk factors for poor outcomes after LS.

Material and methods
A total of 105 patients who underwent surgery for SBO were divided into OS (n = 64) and LS (n = 41) groups, and propensity score-matched analysis was used to compare the short-term and long-term outcomes of the groups. Risk factors for conversion to OS, postoperative complications, and intraoperative bowel injury in LS were also identified.

Results
The incidences of surgical site infection and postoperative ileus were significantly lower in the LS group. The incidence of recurrent bowel did not differ significantly between the two groups. Prior bowel obstruction was a risk factor for conversion of LS to OS (odds ratio (OR) = 24.79, p = 0.0025). Bowel diameter was a risk factor for postoperative complications (OR = 1.50, 95% CI: 1.01–2.22) and for bowel injury (OR = 1.33, 95% CI: 1.05–1.67).

Conclusions
LS for SBO had better postoperative short-term outcomes than OS. The outcomes of LS for SBO were significantly affected by prior bowel obstruction and bowel diameter.

keywords:

small bowel obstruction, laparoscopic surgery, outcome, risk factors
  
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