Khirurgiia · 2025
[Immediate and long-term treatment outcomes in patients with adhesive small bowel obstruction (recurrence rate, redo surgeries and mortality): a multiple-center study].
СтатьяМногоцентровое исследованиеАннотация на английскомНазвание и аннотация: Перевод в очереди
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Tyagunov A E, Abdulkarim B M, Mironenko O N, Semenenko I A, Anosov V D, Sazonov V V, Glagolev N S, Alieva Z M, Sazhin A V
Аннотация
OBJECTIVE: To analyze immediate and long-term outcomes of surgical and non-operative management (NOM) for adhesive small bowel obstruction (ASBO) using the Moscow Unified Medical Information and Analytical System (EMIAS).
MATERIAL AND METHODS. WE: Retrospectively analyzed 366 patients with ASBO in 7 Moscow hospitals between January 01, 2017 and December 31, 2019. Treatment outcomes after surgery and NOM were analyzed throughout 6 years after baseline hospitalization.
RESULTS: At baseline hospitalization, mean hospital-stay for successful NOM was 6.3 (95% CI 4.3-8.2) days shorter compared to surgery (5.5±5.1 vs. 11.8±10.9 days, p<0.001). In-hospital mortality was significantly higher after surgical interventions (12.3% vs. 0.4%, p<0.001). Over a 6-year follow-up, cumulative probability of rehospitalization due to recurrent bowel obstruction was 25.8% for NOM vs. 11.6% for surgery (p=0.005). However, redo surgery rates showed no significant difference: 4.5% (NOM) vs. 5.8% (surgery). Overall survival was higher in non-operated patients (HR 1.82; 95% CI 1.21-2.72; p=0.004).
CONCLUSION: Over a 6-year follow-up, NOM was associated with lower mortality compared to surgical intervention but higher recurrence rates of adhesive small bowel obstruction. The need for reoperation did not differ between both groups.
MATERIAL AND METHODS. WE: Retrospectively analyzed 366 patients with ASBO in 7 Moscow hospitals between January 01, 2017 and December 31, 2019. Treatment outcomes after surgery and NOM were analyzed throughout 6 years after baseline hospitalization.
RESULTS: At baseline hospitalization, mean hospital-stay for successful NOM was 6.3 (95% CI 4.3-8.2) days shorter compared to surgery (5.5±5.1 vs. 11.8±10.9 days, p<0.001). In-hospital mortality was significantly higher after surgical interventions (12.3% vs. 0.4%, p<0.001). Over a 6-year follow-up, cumulative probability of rehospitalization due to recurrent bowel obstruction was 25.8% for NOM vs. 11.6% for surgery (p=0.005). However, redo surgery rates showed no significant difference: 4.5% (NOM) vs. 5.8% (surgery). Overall survival was higher in non-operated patients (HR 1.82; 95% CI 1.21-2.72; p=0.004).
CONCLUSION: Over a 6-year follow-up, NOM was associated with lower mortality compared to surgical intervention but higher recurrence rates of adhesive small bowel obstruction. The need for reoperation did not differ between both groups.