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Surgical Approach for Adhesive Small Bowel Obstruction: Analysis of Risk Factors of Treatment Failure

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Abstract

Adhesive small bowel obstruction is one of the most frequent postoperative morbidities and a major cause of hospital admission. Previous surgery is the most important factor predisposing patients to adhesions. The incidence of adhesive small bowel obstruction after laparotomy has been estimated to be between 12 and 53%, but this incidence increases after major laparotomy (Lancet 353:1476–1480, 1999;Dis Colon Rectum 42:578, 1999; Aust N Z J Surg 63:848–852, 1993; Ann Surg 235:200–206, 2002). Adhesive small bowel obstruction requires appropriate management according to the patient’s condition. Conservative management of ASBO is often successful, with 70 to 80% of patients experiencing resolution of their symptoms without operative intervention (Am J Surg 165(1):121–125, 1993; Am J Surg 196(1):23–27, 2008; J Gastrointest Surg 12(5)926–932, 2008). However, conservative treatment may leave adhesions that could lead to a recurrence of the obstruction. Operative techniques can remove the cause of the obstruction but can lead to the formation of new adhesions. After the operation, the mortality and complication rates have been observed to range from 0 to 3.8% and 14 to 32%, respectively (Ann Surg 240:193–201, 2004; Ann Surg 244:750–757, 2006; Int Surg 74:23–27, 1989; Ann Surg 231:529–537, 2000). Thus, the treatment strategy significantly influences the risk of recurrences and complications (Dis Colon Rectum 48:1140–1146, 2005; Arch Surg 128:765–770, 1993; Am J Surg 170:361–365, 1995). To determine the optimal treatment strategies among patients with adhesive small bowel obstruction from a long-term viewpoint, we evaluated outcomes after treatment for adhesive small bowel obstruction and identified the risk factors for recurrence.

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Authors and Affiliations

  1. Department of Surgery, Ogaki Municipal Hospital, 4-86, Minaninokawa, Ogaki, Gifu, 503-8502, Japan

    Yusuke Tanaka, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama, Takamasa Takahashi, Muneyasu Kiriyama & Kazuaki Seita

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  1. Yusuke Tanaka
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Correspondence to Yusuke Tanaka.

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This study was approved by the Institutional Review Board of Ogaki Municipal Hospital.

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Tanaka, Y., Kaneoka, Y., Maeda, A. et al. Surgical Approach for Adhesive Small Bowel Obstruction: Analysis of Risk Factors of Treatment Failure. Indian J Surg 85, 579–584 (2023). https://doi.org/10.1007/s12262-022-03518-w

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  • DOI: https://doi.org/10.1007/s12262-022-03518-w

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