ANALYSIS OF THE POSSIBILITIES OF VIDEO LAPAROSCOPY IN THE SURGICAL TREATMENT OF ACUTE INTESTINAL OBSTRUCTION
Abstract
Resume. Objective. Comparative analysis of the results of open and laparoscopic interventions in patients with different forms of acute intestinal obstruction (AIO). Patients. We evaluated the results of surgical treatment of 762 patients with acute intestinal obstruction who were divided into two groups: primary laparotomy group of 529 (69.4%) patients and a group of 233 (30.6%) patients in whom surgical intervention was started with diagnostic laparoscopy. Results. The efficacy of therapeutic laparoscopy for phytobezoars was 75.0%, adhesive intestinal obstruction — 69.3%, small intestinal obstruction — 66.7%, sigmoid intestinal pathology — 50.0%, and intussusception — 40.0%. In cases of single adhesions in the abdominal cavity, the efficiency of laparoscopic adhesiolysis was 86.9%; in cases of multiple adhesions, this index decreased to 32.3%. After laparoscopic adhesiolysis, compared to primary laparotomy, early postoperative complications were significantly less frequent (13.0% vs. 43.5%, p<0.001), the period of hospital treatment decreased from 9.31±3.31 to 5.94±1.78 bed-days, and total mortality decreased from 4.9% to 2.6%. Conclusion. The use of laparoscopy in acute intestinal obstruction helps to reduce the overall incidence and severity of postoperative complications. Keywords: acute intestinal obstruction; adhesive obstruction; surgical treatment; videolaparoscopy; adhesiolysis.