Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Dec;38(12):3082-8.
doi: 10.1007/s00268-014-2733-6.

Clinical outcome in acute small bowel obstruction after surgical or conservative management

Raphael P H Meier  1 , Wassila Oulhaci de Saussure, Lorenzo A Orci, Eveline M Gutzwiller, Philippe Morel, Frédéric Ris, Frank Schwenter
Affiliations
Comparative Study

Clinical outcome in acute small bowel obstruction after surgical or conservative management

Raphael P H Meier et al. World J Surg. 2014 Dec.

Abstract

Background: Small bowel obstruction (SBO) is characterized by a high rate of recurrence. In the present study, we aimed to compare the outcomes of patients managed either by conservative treatment or surgical operation for an episode of SBO.

Methods: The outcomes of all patients hospitalized at a single center for acute SBO between 2004 and 2007 were assessed. The occurrence of recurrent hospitalization, surgery, SBO symptoms at home, and mortality was determined.

Results: Among 221 patients admitted with SBO, 136 underwent a surgical procedure (surgical group) and 85 were managed conservatively (conservative group). Baseline characteristics were similar between treatment groups. The median follow-up time (interquartile range) was 4.7 (3.7-5.8) years. Nineteen patients (14.0 %) of the surgical group were hospitalized for recurrent SBO versus 25 (29.4 %) of the conservative group [hazard ratio (HR), 0.5; 95 % CI, 0.3-0.9]. The need for a surgical management of a new SBO episode was similar between the two groups, ten patients (7.4 %) in the surgical group and six patients (7.1 %) in the conservative group (HR, 1.1; 95 % CI, 0.4-3.1). Five-year mortality from the date of hospital discharge was not significantly different between the two groups (age- and sex-adjusted HR, 1.1; 95 % CI, 0.6-2.1). A follow-up evaluation was obtained for 130 patients. Among them, 24 patients (34.8 %) of the surgical group and 35 patients (57.4 %) of the conservative group had recurrent SBO symptoms (odds ratio, 0.4; 95 % CI, 0.2-0.8).

Conclusions: The recurrence of SBO symptoms and new hospitalizations were significantly lower after surgical management of SBO compared with conservative treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Kaplan–Meier estimates of a the hospitalization-free survival, b operation-free survival, c overall survival, and d survival from hospital discharge (i.e., excluding patients who died within 30 days after admission). p values were calculated with the log rank test. Age- and sex-adjusted p values were calculated with multivariate Cox proportional-hazards regression analysis
See this image and copyright information in PMC

References

    1. Nobie B (2012) Small bowel obstruction in emergency medicine. Medscape reference. http://emedicine.medscape.com/article/774140-overview. Accessed 1 Dec 2012
    1. Holzheimer R. Surgical treatment: evidence-based and problem-oriented. Munich: Zuckschwerdt; 2001. - PubMed
    1. Herlinger H. Obstruction. In: Gore RM, Levine MS, Laufer I, editors. Textbook of gastrointestinal radiology. Philadelphia: Saunders; 1994. pp. 931–966.
    1. McEntee G, Pender D, Mulvin D, et al. Current spectrum of intestinal obstruction. Br J Surg. 1987;74:976–980. doi: 10.1002/bjs.1800741105. - DOI - PubMed
    1. Miller G, Boman J, Shrier I, et al. Etiology of small bowel obstruction. Am J Surg. 2000;180:33–36. doi: 10.1016/S0002-9610(00)00407-4. - DOI - PubMed

Publication types

MeSH terms