Scholarlink

Background <p>Postoperative adhesive small bowel obstruction (ASBO) is one of the major complications of abdominal surgery in children. Although the incidence of postoperative ASBO varies according to the type of operation performed, its incidence in children has been estimated to be between 1 and 5%. Surgical intervention is frequently necessary in 35–45% of cases to mitigate the risk of complications such as intestinal perforation and gangrene.</p> Objectives <p>This study aimed to evaluate the safety and efficacy of laparoscopic management for ASBO in children, with a specific focus on patient selection criteria, operative outcomes, and postoperative recovery.</p> Patients and methods <p>We conducted a prospective study from January 2022 to January 2023 involving 34 pediatric patients (aged 3–9&#xa0;years) presenting with ASBO. All patients initially received conservative management including nasogastric decompression and gastrograffin challenge. Laparoscopic intervention was pursued if there was no clinical or radiological improvement after 72&#xa0;h.</p> Results <p>Twenty-six (26) patients (76%) required surgical intervention, six cases (23%) needed for open surgical approach from the start, twenty cases were operated laparoscopically (77%) and 17 cases (85%) were successfully managed laparoscopically. 1 case required conversion to open surgery due to dense bowel adhesions and 2 cases completed laparoscopically with extracorporeal resection after release of adhesions. Mean operative time was 75&#xa0;min (range 30–120), and mean hospital stay was significantly shorter for laparoscopic cases (3&#xa0;days) compared to converted cases (6&#xa0;days). Parental satisfaction with cosmetic outcomes was universally positive.</p> Conclusion <p>Laparoscopic management of ASBO in carefully selected pediatric patients is safe and effective, offering advantages including shorter hospital stays and excellent cosmetic results. Conservative management should remain first-line, with laparoscopy considered when surgical intervention is required.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Laparoscopy for postoperative adhesive intestinal obstruction in pediatrics: is it a good option?

  • 期刊论文

  • 发表日期：

    2025年5月29日

查看全文
  • Ahmed Oshiba,
  • Mostafa Kotb

摘要

Background

Postoperative adhesive small bowel obstruction (ASBO) is one of the major complications of abdominal surgery in children. Although the incidence of postoperative ASBO varies according to the type of operation performed, its incidence in children has been estimated to be between 1 and 5%. Surgical intervention is frequently necessary in 35–45% of cases to mitigate the risk of complications such as intestinal perforation and gangrene.

Objectives

This study aimed to evaluate the safety and efficacy of laparoscopic management for ASBO in children, with a specific focus on patient selection criteria, operative outcomes, and postoperative recovery.

Patients and methods

We conducted a prospective study from January 2022 to January 2023 involving 34 pediatric patients (aged 3–9 years) presenting with ASBO. All patients initially received conservative management including nasogastric decompression and gastrograffin challenge. Laparoscopic intervention was pursued if there was no clinical or radiological improvement after 72 h.

Results

Twenty-six (26) patients (76%) required surgical intervention, six cases (23%) needed for open surgical approach from the start, twenty cases were operated laparoscopically (77%) and 17 cases (85%) were successfully managed laparoscopically. 1 case required conversion to open surgery due to dense bowel adhesions and 2 cases completed laparoscopically with extracorporeal resection after release of adhesions. Mean operative time was 75 min (range 30–120), and mean hospital stay was significantly shorter for laparoscopic cases (3 days) compared to converted cases (6 days). Parental satisfaction with cosmetic outcomes was universally positive.

Conclusion

Laparoscopic management of ASBO in carefully selected pediatric patients is safe and effective, offering advantages including shorter hospital stays and excellent cosmetic results. Conservative management should remain first-line, with laparoscopy considered when surgical intervention is required.