A Study on the Treatment Policy for Intestinal Obstructions in Patients Without a History of Abdominal Surgery

Abstract

We report herein on our review of the treatment policy followed at our hospital to treat intestinal obstructions in patients without a history of abdominal surgery. Few reports in the literature have described such cases. Between 2010 and 2016, 898 patients presented at our hospital with an intestinal obstruction. Among these 898 patients, 59 had no history of abdominal surgery. An operation was needed in 34 (57.6％) of these 59 patients, and an emergency operation was needed in 23 of these 34 patients (39.0％). The mean operation time for open surgery was 85.2 min (18 patients), and the mean operation time for laparoscopic surgery was 74.9 min (16 patients). The most frequent mechanism of obstruction in the 34 patients who underwent an operation was a band-type obstruction (14 patients, 41.2％). In contrast, among the 839 patients with a history of abdominal surgery, an operation was needed in 160 patients (19.1％), and an emergency operation was needed in 70 patients (8.3％). The mean operation time for open surgery was 96.6 min (130 patients), and the mean operation time for laparoscopic surgery was 125.9 min (30 patients). The most frequent mechanism of obstruction in the 160 patients who had previously undergone an operation was intestine/intestine-peritoneum/intestine-intestinal membrane adhesions (83 patients, 51.9％). In patients with intestinal obstruction, surgery was more frequently required in those without a history of abdominal surgery than in those with a history of abdominal surgery. However, technically challenging procedures were not required in patients without a history of abdominal surgery. Thus, laparoscopic surgery could be a good strategy in such cases.