Abstract:
BACKGROUND:Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia and/or ischemia. With the increased popularity of laparoscopy, recent promising reports indicate the feasibility and potential superiority of the minimally invasive approach to the adhesion-encased abdomen. METHODS:The purpose of this study was to assess the outcome of laparoscopic adhesiolysis and to provide technical tips that help in the success of this technique. RESULTS:The most important predictive factor of adhesion formation is a history of previous abdominal surgery ranging from 67%-93% in the literature. Conversely, 31% of scars from previous surgery have been free of adhesions, whereas up to 10% of patients without any prior surgical scars will have spontaneous adhesions of the bowel or omentum. Most intestinal obstructions follow open lower abdominopelvic surgeries such as colectomy, appendectomy, and hysterectomy. The most common complications associated with adhesions are small bowel obstruction (SBO) and chronic pain syndrome. The treatment of uncomplicated SBO is generally conservative, especially with incomplete obstruction and the absence of systemic toxemia, ischemia, or strangulation. When conservative treatment fails, surgical options include conventional open or minimally invasive approaches; the latter have become increasing more popular for lysis of adhesions and the treatment of SBO. Generally, 63% of the length of a laparotomy incision is involved in adhesion formation to the abdominal wall. Furthermore, the incidence of ventral hernia after a laparotomy ranges between 11% and 20% versus the 0.02%-2.4% incidence of port site herniation. Additional benefits of the minimally invasive approaches include a decreased incidence of wound infection and postoperative pneumonia and a more rapid return of bowel function resulting in a shorter hospital stay. In long-term follow up, the success rate of laparoscopic lysis of adhesions remains between 46% and 87%. Operative times for laparoscopy range from 58 to 108 minutes; conversion rates range from 6.7% to 43%; and the incidence of intraoperative enterotomy ranges from 3% to 17.6%. The length of hospitalization is 4-6 days in most series. CONCLUSIONS:Laparoscopic lysis of adhesions seems to be safe in the hands of well-trained laparoscopic surgeons. This technique should be mastered by the advanced laparoscopic surgeon not only for its usefulness in the pathologies discussed here but also for adhesions commonly encountered during other laparoscopic procedures.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Szomstein S,Lo Menzo E,Simpfendorfer C,Zundel N,Rosenthal RJdoi
10.1007/s00268-005-7778-0keywords:
subject
Has Abstractpub_date
2006-04-01 00:00:00pages
535-40issue
4eissn
0364-2313issn
1432-2323journal_volume
30pub_type
杂志文章,评审abstract:PURPOSE:This study was designed to assess the chronological change in health-related quality of life (HRQOL) following robot-assisted distal gastrectomy (RADG) for early gastric cancer (EGC) and to compare the HRQOL of the patients undergoing RADG with that of the general population. METHODS:Patients undergoing RADG f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2390-1
更新日期:2014-05-01 00:00:00
abstract::It is difficult to evaluate precisely the effects of one individual on an entire discipline such as surgery. Indeed, it is impossible to do so when such a discipline spans so vast a country as the United States of America. Nevertheless, as a mountain peak can be seen from afar, so may one perceive the influence of man...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s002689900357
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Pancreaticodudenectomy (PD) is a high-risk, technically demanding operation associated with substantial perioperative morbidity and mortality. This review is intended to evaluate the perioperative outcomes of PD done in a single gastrointestinal surgery unit of a university teaching hospital. PATIENTS AND M...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0589-y
更新日期:2010-08-01 00:00:00
abstract::There have been a growing number of landmark randomized controlled trials published in the orthopedic literature over the past decade. These large-scale trials have had a substantial impact on informing clinical orthopedic practice globally. This review highlights a selected sample of such pivotal trials, across the s...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-019-04955-7
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the prognostic factors associated with long-term outcome after liver resection for colorectal metastases. The retrospective analysis included 297 liver resections for colorectal metastases. METHODS:The variables considered included disease stage, differentiation grade, s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9285-y
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:Gastroesophageal reflux disease (GERD) symptoms are commonly reported in primary hyperparathyroidism (pHPT). Although a calcium-mediated cause-and-effect relationship has been suggested, it remains unknown if parathyroidectomy improves GERD symptoms. METHODS:Over a 22-month period, 1,175 (39%) of 3,000 conse...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2876-5
更新日期:2015-03-01 00:00:00
abstract::Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654771
更新日期:1979-09-20 00:00:00
abstract:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Recently, diagnostic criteria for malnutrition have been proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). This study aimed to investigate the utility of the ESPEN malnutrition criteria as a predictor for major complications following hepatectomy and pancreatectomy. METHODS:Dat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05767-w
更新日期:2021-01-01 00:00:00
abstract:AIM:To evaluate the application value of a three-dimensional (3D) printing model in the training of choledochoscopy techniques. MATERIALS AND METHODS:Imaging data from two patients with biliary dilatation were used to produce two 3D reconstruction models which were subsequently constructed into 3D printing models (No....
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-018-4731-6
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:This study was intended to compare the prognostic power of the number of positive lymph nodes with that of the lymph node ratio in patients with ampullary carcinoma. METHODS:A retrospective analysis was conducted of the medical records of 71 consecutive patients with ampullary carcinoma who underwent pancre...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1175-7
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:There are scant studies that have analyzed the prognostic factors for malignant nonfunctioning endocrine tumors of the pancreas. We identified the predictive factors associated with long-term survival after surgical resection for malignant nonfunctioning endocrine tumors. METHODS:Among the 25 patients seen ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0585-4
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:Postoperative pancreatic fistula (POPF) is a major complication and main cause of mortality after pancreaticoduodenectomy (PD). Afferent loop decompression technique (ALDT) has theoretical feasibility to reduce the rate of POPF. The aim of this study is to determine whether ALDT is a protective factor for PO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4679-6
更新日期:2018-11-01 00:00:00
abstract::Outside Japan portosystemic shunts have been favored as the surgical procedure of choice for the management of portal hypertension of noncirrhotic etiology. Devascularization procedures have resulted in high rebleed rates probably owing to a limited extent of devascularization. We performed this study to assess the ef...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900641
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:The technical complexity of pancreatic resection has made it a specialized procedure performed in high-volume centers. It has been shown that patients operated on in high-volume pancreatobiliary centers have fewer complications and better survival. The purpose of this study was to share our experience with a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2644-6
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) is a condition that has always been perceived to be rare in Asia. The aim of this systematic review was to gather the current available evidence on the incidence of VTE in this population. A secondary aim was to assess the efficacy of pharmacological prophylaxis, and hence determ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2763-0
更新日期:2015-01-01 00:00:00
abstract::This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00353738
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Few studies have focused on the risk factors for failure to achieve fascial closure after use of negative-pressure wound therapy (NPWT) in an open abdomen (OA). We aimed at analyzing possible risk factors for failure of fascial closure and the risk of fistulas after nontrauma lower gastrointestinal (GI) trac...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2360-7
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Scarce data are available on the characteristics of postoperative organ failure (POF) and mortality after gastrectomy. We aimed to describe the causes of organ failure and mortality related to gastrectomy for gastric cancer and to identify patients with POF who are at a risk of failure to rescue (FTR). METH...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05382-9
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The benefit of bullae ablation for the management of primary spontaneous pneumothorax (PSP) has been established. However, various modalities for bullae ablation have been reported from different centers. OBJECTIVE:The present study aimed to assess whether endoloop ligation of bullae was as effective as sta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9928-2
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:We set out to clarify the clinicopathologic characteristics of colorectal liver metastases with macroscopic intrabiliary tumor growth and to determine optimal surgical management. METHODS:Over 15 years, 6 of 103 patients undergoing hepatectomy for colorectal liver metastases had macroscopic intrabiliary tum...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0205-3
更新日期:2006-10-01 00:00:00
abstract::At the time of laparotomy, peritoneal washings were collected from 155 gastric cancer patients and the levels of carcinoembryonic antigen (CEA) determined. The CEA levels in peritoneal washings were statistically independent of those in sera and could more reliably predict the presence of peritoneal metastasis than a ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00316997
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The histone deacetylase (HDAC) inhibitors have emerged as the useful reagents that epigenetically modulate the expression of various genes. In the present study, the effects of HDAC inhibitors on the expression of inflammation-related genes and lung injury during sepsis were investigated. METHODS:Mice were ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0493-5
更新日期:2010-07-01 00:00:00
abstract::Histologically differentiated adenocarcinoma satisfies one of the criteria for limited surgery for mucosal carcinoma of the stomach: however, the histology of the endoscopic biopsy specimen is often different from that of the resected specimen. The medical records of 1018 early gastric carcinomas were retrospectively ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900483
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early-stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reducti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9800-9
更新日期:2009-01-01 00:00:00
abstract::Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012362
更新日期:1999-07-01 00:00:00
abstract:INTRODUCTION:Hypocalcemia is a well-known complication after total thyroidectomy. Studies have indicated that the presence of low postoperative parathyroid hormone (PTH) levels can predict hypocalcemia. However, definitive study designs are lacking. The aim of this study was to determine whether postoperative PTH alone...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4444-2
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Billions of people worldwide lack access to safe affordable surgery. Surgical missions and non-governmental organisations (NGO) are vital in meeting this need, but long-term outcomes are rarely reported. Mercy Ships is a surgical NGO, and we aimed to measure disability-free survival, impact and patient satis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3745-1
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:In patients with well-differentiated thyroid cancer, the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50%. Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients, even if there are no clinically...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1507-2
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Right hepatectomy with caudate lobectomy (RHx) is considered an appropriate procedure for Bismuth type I/II perihilar cholangiocarcinoma in terms of its anatomical and oncological aspect. However, validity of left hepatectomy with caudate lobectomy (LHx) concomitant with arterial resection and reconstruction...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4833-1
更新日期:2019-03-01 00:00:00