Operative versus non-operative management of adhesive small bowel obstruction: A systematic review and meta-analysis

Hajibandeh, Shahab; Panda, Nilanjan; Khan, Rao Muhammad Asaf; Bandyopadhyay, Samik Kumar; Dalmia, Sanjay; Malik, Sohail; Huq, Zahirul; Mansour, Moustafa

doi:10.1016/j.ijsu.2017.07.073

Cited by 53 publications

(34 citation statements)

References 30 publications

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“…[28] The mortality rate of adhesive AMBO has decreased from 5.29% to 3.77% with timely operative management, but there is still a higher mortality risk than with conservative management. [29,30] In the present study, 76.7% of adhesive AMBO cases were managed conservatively and only 23.3% underwent surgery. In all, 44.6% (n=33) of the surgical group had adhesiolysis and 15% (n=5) of the adhesiolysis procedures were performed laparoscopically.…”

Section: Discussionmentioning

confidence: 51%

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Karakaş

Yeşiltaş

Gökçek

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute mechanical bowel obstruction (AMBO) is still a major surgical problem for emergency departments. The aim of this study was to evaluate AMBO in terms of etiology, management, and survival.METHODS: Data of the age, sex, etiology, management, and survival of patients who were hospitalized for bowel obstruction between January 2014 and December 2018 were evaluated retrospectively. Adhesions, tumors, hernias and peritoneal carcinomatosis were evaluated in detail. RESULTS:A total of 735 patients were included in the study. The obstruction was located in the small bowel (AMSBO) in 60% and in the large bowel (AMLBO) in 40%. The mean patient age was 59.9±16.02 years and 52.9% of the patients were male. Adhesion, tumor, and hernia were the most common etiologies of the overall AMBO group (43.3%, 26.2%, and 6%, respectively). The most common etiology for AMSBO was an adhesion (69.3%), while it was a tumor for AMLBO cases (61.6%). The most common management of AMBO patients was a conservative approach (53.2%; adhesions: 76.7%). Surgical palliation was performed in 24.9% (peritoneal carcinomatosis: 65.7%), and resection was performed in 21.9% (volvulus: 61.9%). The mortality rate in the group was 8.6%. The most common etiology was colorectal surgery (51.4%) for adhesions, colorectal cancer (93.8%) for tumors, and incisional hernia (47.7%) in cases of hernia-related AMBO. CONCLUSION:Adhesions, tumors, and hernias are the most common etiologies of AMBO. The incidence of femoral/inguinal hernia have decreased while that of incisional hernia has increased, and it was further observed that peritoneal carcinomatosis has now become as common as hernia as a cause. .). AMBO is described as small (AMSBO) or large (AMLBO) according to the level of the bowel obstruction, and complete or incomplete obstruction according to the discharge of gas. [2] AMBO is observed in the small bowel in 75% to 80% of cases and in the large bowel in 20% to 25%. [3] The etiology of AMBO varies according to considerations such as age, development of the country of occurrence, and the level of the obstruc- ORIGINAL ARTICLEAcute mechanical bowel obstruction (AMBO) is still one of the major surgical problems encountered in emergency departments. AMBO constitutes 3% of all emergency admissions and 15% of acute abdominal pain cases. AMBO is an important cause of mortality as well as costs, as it may involve a long hospital stay, readmissions, and reoperations. [1] AMBO is described as local blockage of intestinal content transit for reasons that may be intramural (e.g., invagination, bezoar,

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Section: Discussionmentioning

confidence: 51%

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Karakaş

Yeşiltaş

Gökçek

et al. 2019

Ulus Travma Acil Cerrahi Derg

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“…However, there is still debate regarding the optimum duration of conservative management and the timing of surgery for SBO, especially when the SBO is due to seat belt injuries, because no high-quality studies have been performed to examine these issues [9,10]. To date, most data with beneficial effects are from case reports or observational studies that enrolled a limited number of patients.…”

Section: Discussionmentioning

confidence: 99%

Delayed bowel obstruction after seat belt injury: a case report

Wang

et al. 2020

BMC Gastroenterol

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Background: Delayed bowel obstruction due to seat belt injury is extremely rare. The delayed onset of nonspecific symptoms makes a timely diagnosis difficult. A deep understanding of the characteristics of this condition is helpful for early diagnosis and treatment. Case presentation: A 39-year-old male was transferred to our hospital from another hospital complaints of progressive abdominal distension and severe weakness. In the previous hospital, he was diagnosed with "adult megacolon" and was recommended for surgical treatment. In our hospital, he was diagnosed with delayed bowel obstruction due to seat belt injury and underwent surgical intervention. Following laparoscopic adhesiolysis and resection of the narrow small intestine, his symptoms improved rapidly, and he was discharged. Conclusion: Delayed bowel obstruction due to seat belt injury may present clinical symptoms any time after the injury. Imaging examination, ileus tube and small colonoscopy may provide us with valuable cues for the diagnosis and treatment of delayed bowel obstruction, and laparoscopy may be an alternative approach in surgical intervention.

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“…During the study period, the first admission for SBO was defined as the index date. Other causes for SBO including malignancy, volvulus, postoperative ileus (within 1 month), inflammatory bowel disease, large bowel obstruction, hernia, radiation-related obstruction, and Meckel's diverticulum were excluded [ 8 – 11 ]. At initial admission, CT scan and blood work were performed for all patients.…”

Section: Methodsmentioning

confidence: 99%

Only Surgical Treatment to Be Considered for Adhesive Small Bowel Obstruction: A New Paradigm

Tabchouri

Dussart

Giger‐Pabst

et al. 2018

Gastroenterology Research and Practice

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Background Adhesive small bowel obstruction (SBO) represents a heavy burden in healthcare systems worldwide and is associated with significant morbidity and mortality. Although conservative treatment alone can lead to SBO resolution in most cases, its optimal duration is still a matter of debate. The aim of this study was to analyze different SBO evolution patterns in order to further determine when to switch to surgical treatment. Study Design All patients who were admitted for adhesive SBO between 2011 and 2016 were reviewed. Patients who had immediate surgery (IS), a successful medical treatment (SMT), and a failed medical treatment (FMT) were compared in terms of overall morbidity, mortality, and SBO recurrence. Results Overall 154 patients were identified, including 23 (14.9%) in IS, 27 (17.5%) in FMT, and 104 (67.6%) in SMT groups. In terms of comorbidities, patients were similar in all groups. Overall morbidity rates were highest in IS and FMT groups (30% and 33%, respectively, vs. 4% in the SMT group, p < 0.001) whereas mortality rate was highest in the FMT group (22% vs. 0% and 0% in IS and SMT groups, respectively, p < 0.001). SBO recurrence rate was highest in the SMT group (22% vs. 4% and 7% in IS and FMT groups, respectively, p = 0.042). Conclusion FMT seems to be associated with similar overall morbidity compared with IS but with increased postoperative mortality. Patient frailty seems to be worsened by prolonged inefficient medical treatment.

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Operative versus non-operative management of adhesive small bowel obstruction: A systematic review and meta-analysis

Cited by 53 publications

References 30 publications

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey

Delayed bowel obstruction after seat belt injury: a case report

Only Surgical Treatment to Be Considered for Adhesive Small Bowel Obstruction: A New Paradigm

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