LAPAROSCOPIC ADHESIOLYSIS-METHOD OF CHOICE IN SELECTED PATIENTS

Abstract

Purpose: The aim of the study is to analyze and estimate the advantages of laparoscopic adhesiolysisin selected patients undergoing laparoscopic adhesiolysis for bowel obstruction in UMHATEM "N.I.Pirogov". Material and Methods:For a three-year period from 01.01.2016 to 01.01.2019 in the Department of General, Visceral and Emergency surgery in UMHATEM "Pirogov", 42 patients with postoperative intestinal adhesions were operated laparoscopically. Out of the 25 (59.52%) were female. In our research, parameters - age, gender, clinical symptoms, mode of treatment, morbidity and mortality were analyzed. Age in this retrospective analysis varied from 18 to 61 years (average 43.7 years). Patients below 18 years of age, and those with tumor data, Crohn's disease and radiation enteritis, were excluded from the study. Results: Age in this research varied from 18 to 61 (average 43.7). Eleven patients (26.19%) underwent conversion. The causes were dense fibrous adhesions in six of them, iatrogenic lesions in three, and haemorrhage in two cases. In two patients, surgery was performed mini-invasive with an intracorporal suture. The hospital stays varied from 4 to 10 days (on average, 6.3 days). The operating time was from 29 to 121min (an average 57.3min). Surgical morbidity was 28.57%, and mortality was not registered. Conclusion: Laparoscopic debridement is an excellent and accurate procedure in selected patients with postoperative abdominal adhesions. The last decade has become a method of choice because of its incontrovertible advantages.

Keywords

• ileus
• postoperative adhesions
• laparoscopy
• adhesiolysis
• conversion