Aim: The aim of this study was to analyse the outcome of laparoscopic management of large bowel obstruction (LBO).
Method: A prospective electronic database (April 2001-June 2009) was used to identify outcomes in consecutive patients presenting with LBO.
Results: Twenty-four patients (13 male) median age 68 years (range 56-92 years), ASA grade I (2), II (6), III (14) and IV (2), underwent surgery for LBO secondary to cancer (21) and diverticulosis (3). Supervised trainees performed four operations. Operations included anterior resection (10), Hartmann's resection (6), right/extended hemicolectomy (7) and colectomy with ileorectal anastomosis (1). The median operating time was 100 min (range 65-180 min). There were two (8%) conversions. The median time to normal diet was 24 h (range 2-192 h) and median hospital stay 3 days (range 1-30 days). Complications, seen in six patients, included atrial fibrillation (2), wound infection (2), ileus (2), CO(2) retention (1), stoma necrosis (1), circulatory collapse/bowel ischaemia (1) and anastomotic leak (1). There was one (4%) readmission and two (8%) returns to theatre. One patient died.
Conclusion: Laparoscopic resectional surgery in acute LBO is feasible and safe with a low complication rate that enables early hospital discharge.
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.