CT量化评估粘连性小肠梗阻患者腹腔镜操作空间的探讨OACSTPCD

Objective:To evaluate the abdominal wall distension index(AWDI)in patients with adhesive small bowel obstruc-tion(ASBO)who underwent prior adhesiolysis,and determine the maximum AWDI compatible with successful laparoscopic adhesioly-sis.Methods:Clinical and imaging data of 68 patients with ASBO who underwent adhesiolysis between Jul.2020 and Nov.2023 were retrospectively analyzed.Patients were divided into the laparoscopic group and the open surgery group based on the surgical approach.Preoperative abdominal CT scans were used to measure and calculate the AWDI.The AWDI,operative time,incidence of bowel strangu-lation,ICU admission rate,postoperative complications,time to oral intake,and hospital stay were compared between the two groups.Results:The AWDI was significantly lower in the laparoscopic group compared to the open surgery group.The laparoscopic group also had significantly shorter time to oral intake and hospital stay(P<0.05).No statistically significant differences were observed between the two groups in terms of operative time,postoperative complications,incidence of bowel strangulation,or ICU admission rate(P>0.05).Themaximum AWDI for laparoscopic group was1.71.Conclusions:The maximum AWDI for laparoscopic adhesiolysis1.71 may serve as a reference for assessing whether sufficient laparoscopic working space can be achieved in patients with ASBO.