Clinical Application Of Laparoscopy Surgery For Chronic Adhesie Intestinal Obstruction

Objective: Combined with the tanalyze of the indications,contraindications,Main points of operation and potential advantages of laparoscopic treatment for chronic adhesive intestinal obstruction,to provide a clinical basis for laparoscopic treatment of chronic adhesive intestinal obstruction.Methods: A retrospective analysis of 42 patients with chronic adhesive intestinal obstruction treated in Department of general surgery of Ningxia People Hospital from March 2014 to March 2018,including 18 cases in laparoscopic surgery group and 24 cases in laparotomy group.The age,sex,body mass index and history of abdominal operation were compared between the two groups,including adhesion level,bleeding volume and small bowel resection,postoperative anal exhaust time,hospitalization time and related complications.Result:1.Two groups of patients were compared before surgery: there was no significant difference in age,body mass index and abdominal operation history between the two groups(P > 0.05).2.Two groups of patients in the intraoperative comparison: laparoscopic surgery group,15 cases of complete laparoscopic surgery,including 2 cases of small bowel resection,1 cases of intestinal adhesions due to separation of laparoscopic assisted surgery.The amount of bleeding(58.06±20.94)ml in the laparoscopic group was significantly lower than that of the open group(126.66±48.51)ml,and the difference was statistically significant(P < 0.05).3.Two groups of patients were compared after operation: Postoperative anal exhaust time(3.55±1.33)d,postoperative ambulation time(12.11±1.08)h and hospitalization time(3.75±1.26)d in laparoscopic group were significantly lower than those in laparotomy group(P < 0.05).The incidence of postoperative complications was 10% in the laparoscopy group and 54% in the laparotomy group,and the difference was significant(P < 0.05).Conclusion:1.Laparoscopic treatment of chronic adhesive intestinal obstruction is safer and has the advantages of minimally invasive,but it is necessary to strictly grasp the indications of operation.2.Compared with the traditional open surgery,laparoscopic surgery can reduce intraoperative bleeding and postoperative anal exhaust time,postoperative bed activity time and length of hospital stay,reduce the occurrence of postoperative complications.