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[Value of the laparoscopy combined with double-balloon enteroscopy in diagnosis and treatment of intestinal diseases].

OBJECTIVE: To evaluate the value of laparoscopy combined with double-balloon enteroscopy (DBE) for the diagnosis and treatment of intestinal diseases.

METHODS: Clinical data of 69 cases with suspected small bowel diseases undergoing laparoscopic and DBE for the diagnosis and treatment were retrospectively analyzed.

RESULTS: The lesions were found in 48 cases by laparoscopy. DBE was required in the remaining 21 patients to identify the underlying condition. All the operations were successfully completed using the laparoscopic approach, including totally laparoscopic bowel resection (n=11), and laparoscopic-assisted bowel resection (n=58). There were no anastomotic leakage, postoperative bleeding, intestinal obstruction, or wound infection. All the patients were discharged within 7 to 9 days after surgery. Postoperative pathological examination showed vascular abnormally (n=10), gastrointestinal stromal tumor (n=20), intestinal adenocarcinoma (n=5), intestinal neurofibroma (n=2), diverticulum (n=5), intestinal mucosal ulceration (n=8), intestinal tuberculosis (n=3), postoperative pouch bleeding (n=1), intestinal polyp (n=6), Crohn's disease (n=5), Meckel diverticulum (n=2), metastatic kidney cancer (n=1), and metastatic lung cancer (n=1). Length of follow up ranged from 3 months to 4 years, during which no re-bleeding occurred, 2 patients with gastrointestinal stromal tumor died of local recurrence and liver metastasis, 1 patient with adenocarcinoma died of local recurrence involving pancreatic head, duodenum, and mesenteric vessels, 2 patients with metastatic disease died of peritoneal recurrence and liver metastasis.

CONCLUSION: Laparoscopic combined with DBE has a high detection rate for small intestinal disease with accurate localization, less trauma, and quicker recovery.

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