Only Surgical Treatment to Be Considered for Adhesive Small Bowel Obstruction: A New Paradigm
Table 2
Outcome according to different SBO therapeutic managements.
IS ()
FMT ()
SMT ()
Total ()
Single band adhesion, n (%)
13 (56.5)
17 (63.0)
—
30 (60.0)
0.774
Extensive adhesions, n (%)
10 (43.5)
10 (37.0)
—
20 (40.0)
0.640
Associated bowel resection, n (%)
5 (21.7)
4 (14.8)
—
9 (18.0)
0.715
Night shift surgery, n (%)
17 (73.9)
13 (48.1)
—
30 (60.0)
1.000
Operative time (min)
120 (70–180)
117 (70–160)
—
120 (70–172)
0.871
Short-term outcome
Overall complications, n (%)
7 (30.4)
9 (33.3)
4 (3.8)
31 (20.1)
<0.001
Grade I–II, n (%)
5 (21.7)
2 (7.4)
3 (2.9)
10 (6.5)
0.004
Grade III–IV, n (%)
2 (8.7)
1 (3.7)
1 (0.9)
4 (3.8)
0.010
Reoperation, n (%)
0
1 (3.7)
0
1 (0.65)
—
Mortality, n (%)
0
6 (22.2)
0
6 (3.9)
<0.001
Anastomotic leak, n (%)
1 (4.3)
3 (11.1)
0
4 (2.6)
0.005
Peritonitis, n (%)
0
2 (7.4)
0
2 (1.3)
0.009
Intra-abdominal collection, n (%)
1 (4.3)
1 (3.7)
0
2 (1.3)
0.119
Superficial abscess, n (%)
1 (4.3)
1 (3.7)
0
2 (1.3)
0.119
Cardiac failure, n (%)
0
0
0
0
1.000
Pulmonary complication, n (%)
0
2 (7.4)
0
2 (1.3)
0.009
Urinary infection, n (%)
4 (17.4)
4 (14.8)
1 (0.9)
9 (5.8)
0.001
Long-term outcome
Follow-up (months)
47 (2–147)
34 (2–57)
34 (2–179)
34.7 (2–179)
0.648
SBO recurrence, n (%)
1 (4.3)
2 (7.4)
23 (22.1)
26 (16.9)
0.042
Stoma requirement, n (%)
1 (4.3)
2 (7.4)
0
3 (1.9)
0.031
Anastomotic stenosis, n (%)
1 (4.3)
0
0
1 (0.6)
0.057
SBO: small bowel obstruction; IS: immediate surgery; FMT: failed medical treatment; SMT: successful medical treatment. Continuous variables are presented as mean (range).
