J Korean Assoc Pediatr Surg.  2013 Jun;19(1):32-38. 10.13029/jkaps.2013.19.1.32.

Early Experience of Laparoscopic Adhesiolysis in Children with Postoperative Intestinal Obstruction

• Lee J
• Jung E
• Park WH
• Choi SO

• KMID: 1427983
• DOI: http://doi.org/10.13029/jkaps.2013.19.1.32

Abstract

The purpose of this study is to analyze the early experience of the laparoscopic adhesiolysis for the intestinal obstruction due to postoperative adhesion. Seven patients were included in this study. The median age of those patients was 13, and there were 3 males and 4 females. Previous diagnosis and surgical procedure were various in seven cases, including small bowel resection with tapering enteroplasty, Boix-Ochoa fundopl ication, Ladd's procedure with appendectomy, mesenteric tumor resection with small bowel anastomosis, ileocecal resection and anastomosis, primary gastric repair, and both high ligation. A successful laparoscopic adhesiolysis was performed in one who had high ligation for inguinal hernia and had a single band adhesion. Six out of 7 (86%) cases needed to convert open surgery due to multiple and dense type of adhesion. In conclusion, laparoscopic approach with postoperative small bowel adhesion seems safe. However, it might be prudently considered because of high rates of conversion in children.

Keyword

Intestinal obstruction; Adhesion; Ileus; Laparoscopy; Children

MeSH Terms

Appendectomy
Child
Female
Hernia, Inguinal
Humans
Ileus
Intestinal Obstruction
Laparoscopy
Ligation
Male

Reference

1. Catena F, Di Saverio S, Kelly MD, Biffl WL, Ansaloni L, Mandala V, et al. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2011; 6:5.

2. Joseph SP, Simonson M, Edwards C. 'Let's Just Wait One More Day': Impact of Timing on Surgical Outcome in the Treatment of Adhesion-Related Small Bowel Obstruction. Am Surg. 2013; 79:175–179.

3. Chowbey PK, Panse R, Sharma A, Khullar R, Soni V, Baijal M. Elective laparoscopy in diagnosis and treatment of recurrent small bowel obstruction. Surg Laparosc Endosc Percutan Tech. 2006; 16:416–422.

4. Zerey M, Sechrist CW, Kercher KW, Sing RF, Matthews BD, Heniford BT. Laparoscopic management of adhesive small bowel obstruction. Am Surg. 2007; 73:773–778. discussion 778-779.

5. Coran AG, Adzick NS. Pediatric surgery. ed 7th. Philadelphia, PA: Elsevier Mosby;2012.

6. Festen C. Postoperative small bowel obstruction in infants and children. Ann Surg. 1982; 196:580–583.

7. Williams SB, Greenspon J, Young HA, Orkin BA. Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum. 2005; 48:1140–1146.

8. Fevang BT, Jensen D, Svanes K, Viste A. Early operation or conservative management of patients with small bowel obstruction? Eur J Surg. 2002; 168:475–481.

9. Eeson GA, Wales P, Murphy JJ. Adhesive small bowel obstruction in children: should we still operate? J Pediatr Surg. 2010; 45:969–974.

10. Bastug DF, Trammell SW, Boland JP, Mantz EP, Tiley EH 3rd. Laparoscopic adhesiolysis for small bowel obstruction. Surg Laparosc Endosc. 1991; 1:259–262.

11. Cirocchi R, Abraha I, Farinella E, Montedori A, Sciannameo F. Laparoscopic versus open surgery in small bowel obstruction. Cochrane Database Syst Rev. 2010; CD007511.

12. O'Connor DB, Winter DC. The role of laparoscopy in the management of acute small-bowel obstruction: a review of over 2,000 cases. Surg Endosc. 2012; 26:12–17.

13. Kim SK, Park SC, Kim WW, Lee SK, Chun SW, Jeon HM, et al. Clinical Analysis of Laparoscopic Adhesiolysis. J Korean Surg Soc. 2001; 60:168–171.

14. Tsao KJ, St Peter SD, Valusek PA, Keckler SJ, Sharp S, Holcomb GW 3rd, et al. Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach. J Pediatr Surg. 2007; 42:939–942. discussion 942.

15. Aguayo P, Fraser JD, Ilyas S, St Peter SD, Holcomb GW 3rd, Ostlie DJ. Laparoscopic management of small bowel obstruction in children. J Laparoendosc Adv Surg Tech A. 2011; 21:85–88.

16. Franklin ME Jr, Gonzalez JJ Jr, Miter DB, Glass JL, Paulson D. Laparoscopic diagnosis and treatment of intestinal obstruction. Surg Endosc. 2004; 18:26–30.

17. Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ. Laparoscopic lysis of adhesions. World J Surg. 2006; 30:535–540.

18. Francois Y, Mouret P, Vignal J. [Obstruction of the small intestine and celioscopic viscerolysis]. Ann Chir. 1994; 48:165–168.

19. Franklin ME Jr, Dorman JP, Pharand D. Laparoscopic surgery in acute small bowel obstruction. Surg Laparosc Endosc. 1994; 4:289–296.