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Recurrence After Operative Treatment of Adhesive Small-Bowel Obstruction

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO.

Methods

We reviewed medical records including operation descriptions from patients who underwent emergency surgery due to ASBO at our institution between 2004 and 2013. Information on the peri- and postoperative periods, including conservatively and surgically treated recurrent ASBO, were obtained from medical records.

Results

In total, 478 patients were included in the study. Of these, 58 (12.1%) patients experienced recurrence of ASBO during median 2.2 years follow-up. Female gender (hazard ratio [HR] 2.00, P = 0.023), multiple/matted adhesions (HR 1.72, P = 0.046), and fascial dehiscence (HR 3.26, P = 0.009) were associated with increased risk of recurrence. Conversely, intestinal resection decreased the risk of recurrence (HR 0.47, P = 0.036).

Conclusions

The overall recurrence rate after surgically treated ASBO was 12.1%, and the risk of recurrence was persistent several years after index operation. Factors associated with an increased risk were female gender, multiple/matted adhesions, and fascial dehiscence.

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Authors and Affiliations

  1. Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark

    Lea Lorentzen, Mari N Øines, Erling Oma, Kristian K Jensen & Lars N Jorgensen

Authors
  1. Lea Lorentzen
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  2. Mari N Øines
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  3. Erling Oma
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  4. Kristian K Jensen
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  5. Lars N Jorgensen
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Contributions

Lea Lorentzen, MD: Conception and design of work, acquisition and interpretation of data, drafting the work, final approval of the version to be published, and agreement to be accountable for all aspects of the work

Mari N Øines, MD: Acquisition of data, revising the work critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work

Erling Oma, MD: Analysis and interpretation of data, revising the work critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work

Kristian K Jensen, MD PhD: Conception and design of work, acquisition and interpretation of data, revising the work critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work

Lars N Jorgensen, MD DMSc: Conception and design of work, interpretation of data, revising the work critically for important intellectual content, final approval of the version to be published, and agreement to be accountable for all aspects of the work

Corresponding author

Correspondence to Lea Lorentzen.

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The authors declare that they have no conflicts of interest.

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Lorentzen, L., Øines, M.N., Oma, E. et al. Recurrence After Operative Treatment of Adhesive Small-Bowel Obstruction. J Gastrointest Surg 22, 329–334 (2018). https://doi.org/10.1007/s11605-017-3604-x

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  • DOI: https://doi.org/10.1007/s11605-017-3604-x

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