Open Access, Peer-reviewed
pISSN 2635-8778
eISSN 2635-8786
    J Korean Assoc Pediatr Surg. 2013 Jun;19(1):32-38. Korean.
    Published online Jun 28, 2013.
    https://doi.org/10.13029/jkaps.2013.19.1.32
    Copyright © 2013 Korean Association of Pediatric Surgeons
    Original Article

    Early Experience of Laparoscopic Adhesiolysis in Children with Postoperative Intestinal Obstruction

    Jeongwoo Lee, M.D., Eunyoung Jung, M.D., Woo-Hyun Park, M.D. and Soon-Ok Choi, M.D.
      • Department of Pediatric Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea.
    • Correspondence: Soon-Ok Choi, M.D., Department of Pediatric Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 194 Dongsan-dong, Jungu, Daegu 700-712, Korea. Tel: 053)250-7323, Fax: 053)250-7322, Email: choi1635@dsmc.or.kr
    Received May 06, 2013; Accepted June 20, 2013.

    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.

    Keywords
    Intestinal obstruction; Adhesion; Ileus; Laparoscopy; Children

    Tables

    Table 1
    Summary of the Case of Patients who was Operated on Laparoscopic Adhesiolysis

    References

      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.
      1. 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.
      1. 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.
      1. 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.
      1. Coran AG, Adzick NS. In: Pediatric surgery. ed 7th. Philadelphia, PA: Elsevier Mosby; 2012.
      1. Festen C. Postoperative small bowel obstruction in infants and children. Ann Surg 1982;196:580–583.
      1. Williams SB, Greenspon J, Young HA, Orkin BA. Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum 2005;48:1140–1146.
      1. 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.
      1. Eeson GA, Wales P, Murphy JJ. Adhesive small bowel obstruction in children: should we still operate? J Pediatr Surg 2010;45:969–974.
      1. Bastug DF, Trammell SW, Boland JP, Mantz EP, Tiley EH 3rd. Laparoscopic adhesiolysis for small bowel obstruction. Surg Laparosc Endosc 1991;1:259–262.
      1. Cirocchi R, Abraha I, Farinella E, Montedori A, Sciannameo F. Laparoscopic versus open surgery in small bowel obstruction. Cochrane Database Syst Rev 2010:CD007511.
      1. 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.
      1. 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.
      1. 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.
      1. 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.
      1. 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.
      1. Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ. Laparoscopic lysis of adhesions. World J Surg 2006;30:535–540.
      1. Francois Y, Mouret P, Vignal J. [Obstruction of the small intestine and celioscopic viscerolysis]. Ann Chir 1994;48:165–168.
      1. Franklin ME Jr, Dorman JP, Pharand D. Laparoscopic surgery in acute small bowel obstruction. Surg Laparosc Endosc 1994;4:289–296.
    MeSH Terms
    Appendectomy
    Child
    Female
    Hernia, Inguinal
    Humans
    Ileus
    Intestinal Obstruction
    Laparoscopy
    Ligation
    Male
    Metrics
    Share
    Tables
    slide

    1 / 1

    PERMALINK