Laparoscopic versus open adhesiolysis for small bowel obstruction – a multicenter, prospective, randomized, controlled trial.
Summary of articles
- Multicenter, prospective, open-label, randomized, controlled trial
- Purpose of this study: comparing laparoscopic adhesiolysis to open surgery in patients with computed-tomography diagnosed adhesive small bowel obstruction that is not resolving with conservative management
- Method: 102 patients. Patients are randomly allocated (1:1) to either laparoscopic or open surgery.
- Outcomes
Both groups are followed
Primary outcomes: the length of postoperative hospital stay in days
Secondary outcomes: the passage of stool, the commencement of enteral nutrition, 30-day mortality, complications, postoperative pain, and the length of sick leave
- Results and conclusion:
Primary outcomes results: 3.75 days in the laparoscopic group and 5 days in
open surgery group
- Relating to my patient
My patient, Mrs. X is a 31 years old female with sudden onset of periumbilical abdominal pain associated with nausea and 2 episodes of non-bloody, non-bilious emesis for 1 day. She is diagnosed with small bowel obstruction with a transition point in the mid ileum. She is made NPO, IVF, NG tube and open surgery are scheduled. According to this article, my patient can be put on laparoscopic, which is has a shorter hospital stay.
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