Only Surgical Treatment to Be Considered for Adhesive Small Bowel Obstruction: A New Paradigm
Table 1
Demographic characteristics and initial SBO clinical, radiological, and biological presentations.
IS ()
FMT ()
SMT ()
Total ()
Demographic characteristics
Age (years)
69 (25–97)
70 (22–104)
76 (16–99)
74 (16–104)
0.115
Gender (M/F)
9/14
12/15
65/39
85/69
0.052
BMI (kg/m2)
23.5 (16.9–81)
20.3 (16.5–30.9)
23.1 (14.8–40.1)
23.8 (14.8–40.1)
0.004
ASA score, n (%)
1–2
19 (82.6)
19 (70.4)
83 (79.8)
121 (78.6)
3–4
4 (17.4)
8 (29.6)
21 (20.2)
33 (21.4)
0.497
Previous SBO, n (%)
14 (60.9)
4 (14.8)
41 (39.4)
59 (38.4)
0.004
Comorbidity, n (%)
Diabetes mellitus, n (%)
0
2 (7.4)
17 (16.4)
19 (12.3)
0.068
Renal failure, n (%)
1 (4.3)
2 (7.4)
13 (12.5)
20 (12.9)
0.437
Peripheral arterial disease, n (%)
4 (17.3)
3 (11.1)
19 (18.3)
26 (16.9)
0.788
Coronary disease, n (%)
2 (8.7)
2 (7.4)
15 (14.4)
19 (12.3)
0.520
Atrial fibrillation, n (%)
1 (4.3)
2 (7.4)
34 (32.7)
37 (24.1)
0.001
Previous stroke, n (%)
2 (8.7)
2 (7.4)
7 (6.7)
11 (7.1)
0.113
Elevated blood pressure, n (%)
12 (52.2)
6 (22.2)
45 (43.3)
63 (40.9)
0.069
COPD, n (%)
3 (13.0)
0
3 (2.9)
6 (3.9)
0.038
Performance status, n (%)
(i) 0
6 (26.1)
8 (29.6)
23 (22.1)
37 (24.1)
0.542
(ii) 1
8 (34.8)
9 (33.3)
46 (44.3)
63 (40.9)
(iii) 2
8 (34.8)
5 (18.5)
23 (22.1)
36 (23.4)
(iv) 3
1 (4.3)
3 (11.1)
10 (9.6)
14 (9.1)
(v) 4
0
2 (7.4)
2 (1.9)
4 (2.6)
Charlson comorbidity index, n (%)
(i) 0
13 (56.5)
13 (48.1)
41 (39.4)
67 (43.5)
0.243
(ii) 1–2
9 (39.1)
9 (33.3)
37 (35.6)
55 (35.7)
(iii) 3–4
1 (4.3)
3 (11.1)
23 (22.1)
27 (17.5)
(iv) ≥5
0
2 (7.4)
3 (2.8)
5 (3.2)
Clinical presentation
Spontaneous abdominal pain, n (%)
22 (95.6)
11 (40.1)
56 (53.9)
89 (57.8)
<0.001
Provoked abdominal pain, n (%)
22 (95.6)
25 (92.6)
73 (70.2)
120 (77.9)
0.004
Radiological presentation
Free peritoneal fluid, n (%)
13 (56.5)
8 (29.6)
13 (12.5)
34 (22.1)
<0.001
Feces sign, n (%)
19 (82.6)
3 (11.1)
20 (19.2)
42 (27.3)
<0.001
Devascularized bowel, n (%)
19 (82.6)
1 (3.7)
2 (1.9)
22 (14.3)
<0.001
Biological presentation
WBC count (G/L)
13.5 (8.3–18.9)
10.2 (5.3–15.6)
10.8 (4.9–17.1)
11.1 (6.2–17.5)
0.042
CRP (mg/L)
32
39.8
26.7
29.8
0.304
SBO: small bowel obstruction; IS: immediate surgery; FMT: failed medical treatment; SMT: successful medical treatment; BMI: body mass index; ASA: American Society of Anesthesiologists; COPD: chronic obstructive pulmonary disease; WBC: white blood cells; CRP: C-reactive protein. Continuous variables are presented as mean (range).
