Laparoscopy reduces the risk of small-bowel obstruction
Open surgery appears to be associated with an increased risk of small-bowel obstructions compared to laparoscopic procedures. This is shown by a new study at the Sahlgrenska Academy, at the University of Gothenburg, Sweden.
In many cases, the surgical technique is the most important factor when it comes to adhesive small-bowel obstruction, even when taking factors such as age, previous operations and other health conditions into account.
This is shown by a study carried out at the University of Gothenburg’s Sahlgrenska Academy, which reviewed 108,141 operations carried out in Sweden between 2002 and 2004.
Nine surgical interventions examined
In the study, published in the journal Archives of Surgery, nine different common surgical and gynaecological interventions were examined. The results show that open surgery increases the risk of small-bowel obstructions by up to four times compared with surgery using laparoscopic techniques.
Reduced risk of bowel obstruction
“Previous studies have shown reduced adhesions after laparoscopic surgery, but this is the first time we have been able to show that it reduces the risk of small bowel obstruction,” says Eva Angenete, researcher at the Sahlgrenska Academy and specialist in surgery at Sahlgrenska University Hospital.
Small Bowel Obstruction Risks
A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chances of developing small bowel obstruction. If you have any of these risk factors, tell your doctor
Hernia
Crohn’s Disease
Cancer
Abdominal surgery
Swallowing a foreign body
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The article, “Effect of Laparoscopy on the Risk of Small-Bowel Obstruction- A Population-Based Register Study”, was published in Archives of Surgery in April.
ABOUT THE SAHLGRENSKA STUDY
The study, which was carried out at the Scandinavian Surgical Outcomes Research Group (SSORG) research unit at the Sahlgrenska Academy and Sahlgrenska University Hospital, was based on data contained in the Swedish National Board of Health and Welfare’s inpatient register regarding care or operations for small-bowel obstructions up to five years after an operation (gall bladder surgery, appendix operations and intestinal operations).
Causes, incidence, and risk factors
Obstruction of the bowel may due to-
A mechanical cause, which simply means something is in the way
Ileus, a condition in which the bowel doesn’t work correctly but there is no structural problem
Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include
- Chemical, electrolyte, or mineral disturbances (such as decreased potassium levels)
- Complications of intra-abdominal surgery
- Decreased blood supply to the abdominal area (mesenteric artery ischemia)
- Injury to the abdominal blood supply
- Intra-abdominal infection
- Kidney or lung disease
- Use of certain medications, especially narcotics
In older children, paralytic ileus may be due to bacterial, viral, or food poisoning (gastroenteritis), which is sometimes associated with secondary peritonitis and appendicitis.
Mechanical causes of intestinal obstruction may include
- Abnormal tissue growth
- Adhesions or scar tissue that form after surgery
- Foreign bodies (ingested materials that obstruct the intestines)
- Gallstones
- Hernias
- Impacted feces (stool)
- Intussusception
- Tumors blocking the intestines
- Volvulus (twisted intestine)
ABOUT SMALL-BOWEL OBSTRUCTIONS
Small-bowel obstruction – is a common cause of emergency admissions, and is caused by an obstruction in the small or large intestine, which can lead to pain, swelling and feelings of sickness and require emergency surgery. One common cause of small-bowel obstruction is abdominal adhesions, caused by surgical trauma to the peritoneum.
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Eva Angenete
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46-031-343-8410
University of Gothenburg