Laparoscopic Adhesiolysis in Acute Mechanical Intestinal Obstruction Due to Adhesion

Özet

Objective: The aim of the study was to discuss our clinical experience of laparoscopic adhesiolysis in acute mechanical bowel obstruction (MBO) due to post-operative adhesion in the light of the literature. Methods: Patients who underwent laparoscopic adhesiolysis due to acute MBO due to adhesion between January 2014 and December 2019 were included in the study. Diagnosis of acute MIO was put with patient’s history, clinical examination findings, standing direct abdominal radiography, and computed tomography. Laparoscopic adhesyolysis was applied to those who did not respond to conservative treatment at the end of 24–48 h. Results: Twenty-four patients with laparoscopic adhesiolysis were included in the study. Sixteen of the patients were women and eight were men. The average age was 52 years (27–74). Post-operative MBO due to adhesion and dilatation in the proximal of the adhesion was observed in the distal ileum in 14 patients, in the proximal jejunum in ten patients. For 4 (16.7%) patients, it was switched to open surgery due to technical difficulties. Douglas drain was placed in seven of the patients to monitor the risk of possible bleeding and intestinal perforation. Oral intake was started in patients whose abdominal pain and nausea complaints regressed on the 1st post-operative day. Patients were discharged after an average post-operative 4.2 (2–8) days. Loop ileostomy was performed in one patient, when intestinal contents came from the drain on the post-operative on the 3rd day. Post-operative mortality was not observed in any of our patients. Conclusion: In light of the increasing use of laparoscopic surgery in recent years, due to the disadvantages of the conventional surgical method in acute MBO due to post-operative adhesion, we believe that the laparoscopic approach will safely become widespread.