Application of Laparoscopy to the Diagnosis and Treatment for Intestinal Obstruction: a Report on 46 Cases
10.3969/j.issn.1673-9701.2010.23.011
- VernacularTitle:应用腹腔镜诊治肠梗阻46例报道
- Author:
Zhiyong LI
1
;
Jiaxing LI
;
Zhonghong LI
Author Information
1. 广西钦州市第一人民医院
- Keywords:
Intestinal obstruction (bowel obstruction);
Laparoscopy;
Value of diagnosis and treatment
- From:
China Modern Doctor
2010;48(23):23-25,30
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of laparoscopic diagnosis and treatment for intestinal obstruction. Methods Retrospective analysis to the clinical data of 46 cases of intestinal obstruction admitted to hospital from February 2006 to February 2009 with the application of laparoscopy. Preoperative diagnosis declared: 36 cases of adhesive intestinal obstruction, 1 case of volvulus, 3 cases of tumor, 6 eases of unconfirmed diagnosis. Results Diagnosis: 6 cases of unconfirmed diagnosis were confirmed with the help of laparoscopy. Treatment: single adhesiolysis for 32 cases of adhesive obstruction were successfully carried out under laparoscopy. 3 cases released from adhesive obstruction by cutting of the peritoneal adhesions with ultrasonic-harmonic scalpel. For 2 cases whose adhesive band lain between intestines, the separation of adhesions and the repair of intestinal wall were carried out manually from the extended puncture wound. 1 case of complex adhesion needed to conversion to laparotomy. For 2 cases of suspected intestines necrosis, the segments which are pathological deteriorated were pulled out through the extended puncture wound, cut of and created anastomosis. 2 cases of intestinal obstruction caused by sigmoid volvulus were released by the way of using instruments such as intestinal clamp to turn the obstructed intestines into normality. 1 case of necrosis of obstructed intestine caused by sigmoid volvulus was conversed to laparotomy to get rid of the necrosis part and temporary colostomy. Colonic anastomosis was carried out 3weeks later. 3 cases of obstruction caused by colon cancer undergone radical operation in the way of laparoscopic-assisted. In the follow-up of 45 cases, 3 cases recurred, which rate is 6.7%. Conclusion Application of laparoscopy to the diagnosis of intestinal obstruction is of high confirmed diagnosis rate, especially of important clinical value for some cases of unclear pathogeny. There is also an advantage for the treatment.Operation is performed in a relatively enclosed space, therefore the postoperative intestinal adhesion recurrence can be significantly reduced.
