Langenbeck's Archives of Surgery

, Volume 403, Issue 5, pp 555–559 | Cite as

Randomized controlled trial of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction

  • Yasuyuki Fukami
  • Satoshi Kobayashi
  • Ei Sekoguchi
  • Yasuhiro Kurumiya
Controlled Clinical Trials



Hyperbaric oxygen (HBO) therapy is a controversial treatment for adhesive postoperative small bowel obstruction (ASBO), with only a few retrospective studies reported. The aim of this study was to assess the clinical impact of HBO therapy in the treatment of ASBO.


Patients with ASBO were randomly assigned to no-HBO (standard arm) or HBO (intervention arm). Patients of the intervention arm were treated once daily at a pressure of 2.0 atm absolute and received 100% oxygen. The primary endpoint was the success rate of medical treatment. This study was registered at the UMIN Clinical Trial Registry as UMIN000010399.


The no-HBO group included 40 patients, and the HBO group included 33 patients. Patient characteristics, time to oral intake, and length of hospital stay were similar between the two groups. No significant differences were noted between the no-HBO and HBO groups in the need for long intestinal tube decompression (20.0 versus 18.2%, respectively, p = 1.000) and the need for operative intervention (10.0 versus 18.2%, respectively, p = 0.332). The overall success rate of medical treatment was 72.5% in the no-HBO group and 78.8% in the HBO group (p = 0.594).


In this randomized controlled trial, HBO for ASBO has no additional effect in medical treatment.


Hyperbaric oxygen therapy Adhesive small bowel obstruction Postoperative ileus Surgery Complication 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This trial was approved by the Institutional Review Board. This study was registered at the UMIN Clinical Trial Registry as UMIN000010399.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Seror D, Feigin E, Szold A, Allweis TM, Carmon M, Nissan S, Freund HR (1993) How conservatively can postoperative small bowel obstruction be treated? Am J Surg 165:121–125CrossRefPubMedGoogle Scholar
  2. 2.
    Cox MR, Gunn IF, Eastman MC, Hunt RF, Heinz AW (1993) The operative aetiology and types of adhesions causing small bowel obstruction. Aust N Z J Surg 63:848–852CrossRefPubMedGoogle Scholar
  3. 3.
    Matter I, Khalemsky L, Abrahamson J, Nash E, Sabo E, Eldar S (1997) Does the index operation influence the course and outcome of adhesive intestinal obstruction? Eur J Surg 163:767–772PubMedGoogle Scholar
  4. 4.
    Bueno-Lledó J, Barber S, Vaqué J, Frasson M, Garcia-Granero E, Juan-Burgueño M (2016) Adhesive small bowel obstruction: predictive factors of lack of response in conservative management with gastrografin. Dig Surg 33:26–32CrossRefPubMedGoogle Scholar
  5. 5.
    Farid M, Fikry A, El Nakeeb A, Fouda E, Elmetwally T, Yousef M et al (2010) Clinical impacts of oral gastrografin follow-through in adhesive small bowel obstruction (SBO). J Surg Res 162:170–176CrossRefPubMedGoogle Scholar
  6. 6.
    Fukami Y, Kurumiya Y, Mizuno K, Sekoguchi E, Kobayashi S (2014) Clinical effect of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction. Br J Surg 101:433–437CrossRefPubMedGoogle Scholar
  7. 7.
    Choi HK, Chu KW, Law WL (2002) Therapeutic value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: a prospective randomized trial. Ann Surg 236:1–6CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Biondo S, Parés D, Mora L, Martí Ragué J, Kreisler E, Jaurrieta E (2003) Randomized clinical study of gastrografin administration in patients with adhesive small bowel obstruction. Br J Surg 90:542–546CrossRefPubMedGoogle Scholar
  9. 9.
    Williams SB, Greenspon J, Young HA, Orkin BA (2005) Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum 48:1140–1146CrossRefPubMedGoogle Scholar
  10. 10.
    Ji ZL, Li JS, Yuan CW, Chen WD, Zhang YN, Ju XT, Tang WH (2010) Therapeutic value of sesame oil in the treatment of adhesive small bowel obstruction. Am J Surg 199:160–165CrossRefPubMedGoogle Scholar
  11. 11.
    Fleshner PR, Siegman MG, Slater GI, Brolin RE, Chandler JC, Aufses AH Jr (1995) A prospective, randomized trial of short versus long tubes in adhesive small-bowel obstruction. Am J Surg 170:366–370CrossRefPubMedGoogle Scholar
  12. 12.
    Tibbles PM, Edelsberg JS (1996) Hyperbaric-oxygen therapy. N Engl J Med 334:1642–1648CrossRefPubMedGoogle Scholar
  13. 13.
    Leach RM, Rees PJ, Wilmshurst P (1998) Hyperbaric oxygen therapy. Br Med J 317:1140–1143CrossRefGoogle Scholar
  14. 14.
    Akin ML, Uluutku H, Erenoglu C, Ilicak EN, Elbuken E, Erdemoglu A, Celenk T (2002) Hyperbaric oxygen ameliorates bacterial translocation in rats with mechanical intestinal obstruction. Dis Colon Rectum 45:967–972CrossRefPubMedGoogle Scholar
  15. 15.
    Chen MJ, Chen TY, Cheng YM, Hsu YC (2012) The effect of postoperative hyperbaric oxygen treatment on intra-abdominal adhesions in rats. Int J Mol Sci 13:12224–12231CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ohno Y, Kanematsu T (1998) Hyperbaric oxygen therapy for intestinal obstruction in children: an exceptional experience in a compromised child. J Pediatr Surg 33:1543–1545CrossRefPubMedGoogle Scholar
  17. 17.
    Ambiru S, Furuyama N, Kimura F, Shimizu H, Yoshidome H, Miyazaki M, Ochiai T (2008) Effect of hyperbaric oxygen therapy on patients with adhesive intestinal obstruction associated with abdominal surgery who have failed to respond to more than 7 days of conservative treatment. Hepatogastroenterology 55:491–495PubMedGoogle Scholar
  18. 18.
    Knighton DR, Halliday B, Hunt TK (1986) Oxygen as an antibiotic. A comparison of the effects of inspired oxygen concentration and antibiotic administration on in vivo bacterial clearance. Arch Surg 121:191–195CrossRefPubMedGoogle Scholar
  19. 19.
    Abu-Asi MJ, Andreyev HJ (2013) The utility of hyperbaric oxygen therapy to treat recurrent acute bowel obstruction after previous pelvic radiotherapy: a case series. Support Care Cancer 21:1797–1800CrossRefPubMedGoogle Scholar
  20. 20.
    West JB (1999) The original presentation of Boyle’s law. J Appl Physiol 87:1543–1545CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryToyota Kosei HospitalToyotaJapan

Personalised recommendations