Laparoscopic adhesiolysis: consensus conference guidelines

被引：36

作者：

Vettoretto, N. ^{[1
]}

Carrara, A. ^{[2
]}

Corradi, A. ^{[3
]}

De Vivo, G. ^{[4
]}

Lazzaro, L. ^{[5
]}

Ricciardelli, L. ^{[6
]}

Agresta, F. ^{[7
]}

Amodio, C. ^{[8
]}

Bergamini, C. ^{[9
]}

Borzellino, G. ^{[10
]}

Catani, M. ^{[11
]}

Cavaliere, D. ^{[12
]}

Cirocchi, R. ^{[13
]}

Gemini, S. ^{[14
]}

Mirabella, A. ^{[15
]}

Palasciano, N. ^{[16
]}

Piazza, D. ^{[17
]}

Piccoli, M. ^{[18
]}

Rigamonti, M. ^{[19
]}

Scatizzi, M. ^{[20
]}

Tamborrino, E. ^{[21
]}

Zago, M.

机构：

[1] M Mellini Hosp, Laparoscop Surg Unit, Chiari, Italy

[2] Santa Chiara Hosp, Trento, Italy

[3] Bolzano Hosp, Bolzano, Italy

[4] Bassano Grappa Hosp, Vicenza, Italy

[5] S Tommaso Battuti Hosp, Portogruaro, Italy

[6] Cotugno Hosp, Naples, Italy

[7] Civil Hosp, Adria, Italy

[8] Santa Croce Hosp, Fano, Italy

[9] Careggi Hosp, Florence, Italy

[10] Univ Verona, Dept Surg, I-37100 Verona, Italy

[11] Univ Roma La Sapienza, Rome, Italy

[12] Morgagni Pierantoni Hosp, Forli, Italy

[13] Univ Perugia, S Maria Hosp, Terni, Italy

[14] G Brotzu Hosp, Cagliari, Italy

[15] Villa Sofia Cervello Hosp Trust, Palermo, Italy

[16] Univ Policlin Bari, Bari, Italy

[17] Vittorio Emanuele Hosp, Catania, Italy

[18] S Agostino Estense Hosp, Baggiovara, Italy

[19] Civil Hosp, Cles, Italy

[20] Misericordia & Dolce Hosp, Prato, Italy

[21] S Maria Bianca Hosp, Mirandola, Italy

来源：

COLORECTAL DISEASE | 2012年 / 14卷 / 05期

关键词：

Laparoscopy; surgery; critical care; adhesions; small bowel obstruction; SMALL-BOWEL OBSTRUCTION; INGUINAL-HERNIA REPAIR; POSTOPERATIVE ADHESIONS; ABDOMINAL ADHESIONS; INTESTINAL ISCHEMIA; CROHNS-DISEASE; WORLD SOCIETY; MESH REPAIR; FOLLOW-UP; MANAGEMENT;

D O I：

10.1111/j.1463-1318.2012.02968.x

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Aim Laparoscopic adhesiolysis has been demonstrated to be technically feasible in small bowel obstruction and carries advantages in terms of post-surgical course. The increasing dissemination of laparoscopic surgery in the emergency setting and the lack of concrete evidence in the literature have called for a consensus conference to draw recommendations for clinical practice. Methods A literature search was used to outline the evidence, and a consensus conference was held between experts in the field. A survey of international experts added expertise to the debate. A public jury of surgeons discussed and validated the statements, and the entire process was reviewed by three external experts. Results Recommendations concern the diagnostic evaluation, the timing of the operation, the selection of patients, the induction of the pneumoperitoneum, the removal of the cause of obstructions, the criteria for conversion, the use of adhesion-preventing agents, the need for high-technology dissection instruments and behaviour in the case of misdiagnosed hernia or the need for bowel resection. Conclusion Evidence of this kind of surgery is scanty because of the absence of randomized controlled trials. Nevertheless laparoscopic skills in emergency are widespread. The recommendations given with the consensus process might be a useful tool in the hands of surgeons.

引用

页码：e208 / e215

页数：8

共 89 条

[1] Oral water soluble contrast for the management of adhesive small bowel obstruction (Withdrawn Paper. 2007, art. no. CD004651) [J].