ANALYSIS OF RISK FACTORS FOR CONVERSION FROM LAPAROSCOPIC SURGERY FOR SMALL BOWEL OBSTRUCTION TO OPEN SURGERY ckosugi0126@yahoo.co.jp

PE018

ANALYSIS OF RISK FACTORS FOR CONVERSION FROM LAPAROSCOPIC SURGERY FOR SMALL BOWEL OBSTRUCTION TO OPEN SURGERY

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Japan

Poster Exhibition only

We report on the appropriateness of laparoscopic surgery for intestinal obstruction by examining the outcomes of laparoscopic surgery for small bowel obstruction in our department and analyzing the risk factors for conversion to open surgery.

80 cases of laparoscopic surgery for intestinal obstruction performed in our department. We examine the risk factors for conversion to large laparotomy and laparoscopic surgery combined with small incision (small incision of 4 cm or less).

There were 11 cases (13.8%) converted to laparotomy and 41 cases (51.3%) converted to laparoscopic surgery combined with small incision. There were 2 cases of difficulty in extensive adhesion removal, but 1 case of poor intestinal decompression, 4 cases of strangulation, and 5 cases of difficulty in securing a visual field, for a total of 9 cases, conversion to large laparotomy was impossible due to inability to secure working space. Multivariate analysis revealed no clear risk factors, but cases with a history of pelvic surgery (p = 0.094) and strangulating ileus (p = 0.064) tended to progress to major laparotomy. Multivariate analysis revealed that age 73 years or older (p = 0.087) and a history of two or more previous laparotomies (p = 0.097) tended to be risk factors for cases requiring a mini incision.

In laparoscopic surgery for small intestinal obstruction, no statistical risk factors were found for progress to major or mini laparotomy, but the results suggest that a history of pelvic surgery and cases with strangulating ileus are more likely to progress to major laparotomy.