복강경하 유착박리술의 임상분석
Clinical Analysis of Laparoscopic Adhesiolysis
김성근, 박승철, 김원우, 이상권, 천성원, 전해명, 김응국,
소속 상세정보
김성근 ( Kim Sung-Kun )
가톨릭대학교 의과대학 성모병원 내시경수술센터
박승철 ( Park Seung-Chul )
가톨릭대학교 의과대학 성모병원 내시경수술센터
김원우 ( Kim Won-Woo )
가톨릭대학교 의과대학 성모병원 내시경수술센터
이상권 ( Lee Sang-Kuon )
가톨릭대학교 의과대학 성모병원 내시경수술센터
천성원 ( Chun Sung-Won )
가톨릭대학교 의과대학 성모병원 내시경수술센터
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 성모병원 내시경수술센터
김응국 ( Kim Eung-Kook )
가톨릭대학교 의과대학 성모병원 내시경수술센터
KMID : 0371320010600020168
Abstract
Purpose: Laparoscopic management of intestinal obstruction is hypothetically attractive, However little is known about this procedure in our country. With new advances in diagnostic and therapeutic tools such as laparoscopic procedures, the management of intestinal obstruction has become feasible.
Methods: In order to analyze the clinical results of laparoscopic adhesiolysis, a retrospective review of a consecutive series of 20 cases of intestinal obstruction unresponsive to medical management was done between 1997 and 2000.
Results: The mean surgical time for the laparoscopic procedure was 75 min and two cases were converted to open surgery due to dense adhesion and intestinal strangulation. The characterization of adhesion type included 10 cases with simple fibrotic band, 4 cases with multiple fibrotic band and 5 cases with dense adhesion. Additionally, the most common site for adhesion was the small intestine and colon (12 cases). The mean diet start time was 2.3 days, mean hospital stay was 4.7 days and totally mean analgesic use was 1.6 times.
Conclusion: Laparoscopic management of adhesive bowel obstruction is feasible and safe in experienced hands. The laparoscopic procedure also is an excellent diagnostic modality in case of obstruction, and the majority of these cases can be simultaneously managed laparoscopically. A laparoscopic approach is recommend as a first choice of treatment for selective cases of intestinal adhesion.
키워드
복강경 수술;유착;유착박리
Laparoscopic; Adhesive ileus; Adhesiolysis
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