Clinical characteristics of laparoscopic adhesiolysis for adhesive small bowel obstruction in children

Abstract

Objective To evaluate the outcomes of the laparoscopic adhesiolysis to small bowel obstruction (SBO) in children.Methods Clinical data of 47 cases of laparoscopic adhesiolysis to adhesion SBO from January 2008 to January 2013 were retrospectively analyzed.All of them experienced only once surgery history.Results All laparoscopic surgery were successfully completed without laparotomic conversions,there were no incisional hernia,wound infection and pneumonia complications.Adhesions located in the right upper quadrant of 7 cases,the right lower quadrant of 31 cases,the left upper quadrant of 3 cases and the left lower quadrant of 6 cases.The cause of obstruction was a single band (n =5),more than 2 bands (n =22),anterior abdominal wall adhesions (n =8) and extensive dense adhesions(n =12).Two patients with intestinal extensive dense adhesions were appeared SBO again,they were cured by laparotomy of intestinal resection and anastomosis.Small intestine was ruptured in another 2 cases,they were cured by endoscopic suture.The operative time for the bands caused SBO groups was shorter than that for the anterior abdominal wall adhesions or extensive dense adhesions caused SBO groups(P＜0.05).All patients were cured after surgery,and no adhesion SBO,intractable recurrent abdominal pain or malnutrition was found during postoperative follow-up (3-60m).Conclusions Laparoscopic adhesiolysis is safe,feasible and effective to treat adhesion SBO in children.For children with extensive dense intestinal adhesions,the indication for laparoscopic adhesiolysis should be more strictly controlled. Key words: Laparoscopy; Intestinal obstruction; Reoperation