Adrian Dorin Bordei

Adrian Dorin Bordei

Intestinal Obstruction Secondary to Postoperative Peritoneal Adhesions: the Tolerability of the Conservative Treatment

The present study aims to determine the mean duration of the conservative management that can be tolerated by the patients with intestinal obstruction secondary to the postoperative peritoneal adhesions, in order to postpone the surgical intervention. Material and method: The data of the patients with intestinal obstruction secondary to postoperative peritoneal adhesions were retrospectively collected and analysed. The number of readmissions, the type of the therapeutic management, the duration of the conservative treatment, the number of surgical reinterventions and the intraoperative aspect represented the studied variables. Results: 543 patients with intestinal obstruction secondary to postoperative peritoneal adhesions, admitted in the Surgical Department of Sfantul Pantelimon Emergency Hospital from Bucharest, Romania, between January 2014 and July 2018, were enrolled in the study. 233 patients underwent conservative treatment, 310 patients being surgically treated. The mean interval necessary for the monitoring of the patients non- operatively treated was 7 days, within a range of 2 to 14 days. For the surgically treated cases, the mean monitoring interval was 5 days, within a range of 1 to 14 days. Among the patients that underwent surgical treatment, there were 276 cases of adhesiolysis, 31 cases of intestinal resection with anastomosis and 3 cases of intestinal resection with terminal ileo- or colostomy. Conclusion: Under strict monitoring, a signifi cant number of cases of intestinal obstruction secondary to postoperative peritoneal adhesions can, successfully, be treated using conservative management, within 7-10 days.

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Postoperative Peritoneal Adhesion Syndrome - a Challenging Issue in Laparoscopic Surgery

The presence of the peritoneal adhesions during surgery represents an element that can negatively influence the intra- and postoperative evolution of the patients. This article aims to evaluate the impact of the peritoneal adhesions on the postoperative recovery of the patients. Material and method: The data of 1407 patients undergoing laparoscopic cholecystectomy between January 2014 and October 2018 were retrospectively analyzed. Patients were organized into two groups: the case group, consisting of patients for whom peritoneal adhesions were identifi ed during the surgical intervention, and the control group, with patients that had no postoperative peritoneal adhesions. The degree of association between the presence of the peritoneal adhesions and the operative time, the risk of laparoscopic conversion to laparotomy and the risk of intra- or postoperative complications was analyzed. Results: For 537 patients (38.16%) included in the study postoperative peritoneal adhesions were identified at the time of the laparoscopic cholecystectomy.

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