A new study has found that minimally invasive abdominal and pelvic laparoscopy correlated with fewer incidents of small-bowel obstruction (SBO) over time.

Researchers at the University of Gothenburg (Sweden) and the Swedish National Board of Health and Welfare (Socialstyrelsen; Stockholm) conducted a population-based retrospective study involving 108,141 inpatients registered by the Socialstyrelsen, to inspect the incidence and risk factors for SBO. The researchers identified demographic characteristics, comorbidity, previous abdominal surgery, and death data for several procedures, including cholecystectomy, hysterectomy, bowel resection, anterior resection, rectopexy, appendectomy, and bariatric surgery. The main outcome measures were episodes of hospital stay and surgery for SBO within five years after the surgery.

The results showed that the incidence of SBO ranged from 0.4%-13.9%, and open surgery seems to increase the risk of SBO at least 4 times compared with laparoscopy for most of the abdominal surgical procedures studied. Multivariate analysis revealed age, previous surgery, comorbidity, and surgical technique to be risk factors for SBO; laparoscopy exceeded other risk factors in reduction of the risk of SBO for most of the surgical procedures. The study was published in the April 2012 issue of Archives of Surgery.

“Of the possible factors to examine in a population-based registry, our study identified the surgical technique, open versus laparoscopic, to be one of the more important for the risk of SBO,” concluded lead author Eva Angenete, MD, PhD, and colleagues. “Adhesion-related morbidity is related to substantial health care costs and, as a complication of surgery, it is becoming a medico-legal issue. Reduction of adhesion-related morbidity, such as SBO, is thus of importance for patients as well as for society.”

The leading cause of SBO in industrialized countries is postoperative adhesions (60%). Surgeries most closely associated with SBO are appendectomy, colorectal surgery, and gynecologic and upper gastrointestinal (GI) procedures. SBOs can be partial or complete, simple or strangulated. If not diagnosed and properly treated, vascular compromise leads to bowel ischemia and further morbidity and mortality. Because as many as 40% of patients have strangulated obstructions, SBO accounts for 20% of all acute surgical admissions.

http://www.gzjiayumed.com/en/index.asp