American journal of surgery · 2026
Success of conservative management and associated factors among patients with postoperative adhesive small bowel obstruction at comprehensive specialized hospitals in Central Ethiopia.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Fikre Endale, Ersamo Tseganesh, Tekletsadik Yegle Asrat, Markos Zekarias, Lorato Sintayehu Samuel, Tsahay Mellese, Baraki Betelihem Girma, Gebrehiwot Gediwon
Аннотация
BACKGROUND: Postoperative adhesive small bowel obstruction (ASBO) is a common surgical complication. Conservative management is often attempted, but success varies. This study assessed the success rate and factors associated with conservative management of ASBO in Central Ethiopia.
METHODS: A retrospective cross-sectional study was conducted among patients managed from January 2017 to December 2024 at Wchemo University NigistEleni Mohammed Memorial Comprehensive Specialized Hospital (WCUNEMMCSH), WCSH (Worabe Comprehensive Specialized Hospital), and Wolkite University Comprehensive Specialized Hospital (WKUCSH). Data were collected using Kobo Collect and analyzed in SPSS v26. Variables with p < 0.25 in bivariable logistic regression were included in multivariable analysis, with p < 0.05 considered significant.
RESULTS: Of 336 patients (response rate 97.94%), 63.4% (95% CI: 58.0-68.6) had successful conservative management. Multivariable analysis identified factors negatively associated with success: vomiting (AOR = 0.476; p = 0.024), abdominal distension (AOR = 0.301; p = 0.001), guarding/rebound tenderness (AOR = 0.354; p = 0.022), obstruction 13-60 months (AOR = 0.427; p = 0.037) and >60 months post-surgery (AOR = 0.327; p = 0.028), non-distended/gasless colon (AOR = 0.341; p = 0.001), and air-fluid levels >5 mm (AOR = 0.338; p = 0.001). Generalized tenderness was positively associated with success (AOR = 1.903; p = 0.034).
CONCLUSION: Conservative management of ASBO was successful in 63.4% of patients. Clinical symptoms, physical examination, duration since surgery, and plain abdominal X-ray findings can help predict patients at risk of conservative treatment failure, supporting timely surgical intervention.
METHODS: A retrospective cross-sectional study was conducted among patients managed from January 2017 to December 2024 at Wchemo University NigistEleni Mohammed Memorial Comprehensive Specialized Hospital (WCUNEMMCSH), WCSH (Worabe Comprehensive Specialized Hospital), and Wolkite University Comprehensive Specialized Hospital (WKUCSH). Data were collected using Kobo Collect and analyzed in SPSS v26. Variables with p < 0.25 in bivariable logistic regression were included in multivariable analysis, with p < 0.05 considered significant.
RESULTS: Of 336 patients (response rate 97.94%), 63.4% (95% CI: 58.0-68.6) had successful conservative management. Multivariable analysis identified factors negatively associated with success: vomiting (AOR = 0.476; p = 0.024), abdominal distension (AOR = 0.301; p = 0.001), guarding/rebound tenderness (AOR = 0.354; p = 0.022), obstruction 13-60 months (AOR = 0.427; p = 0.037) and >60 months post-surgery (AOR = 0.327; p = 0.028), non-distended/gasless colon (AOR = 0.341; p = 0.001), and air-fluid levels >5 mm (AOR = 0.338; p = 0.001). Generalized tenderness was positively associated with success (AOR = 1.903; p = 0.034).
CONCLUSION: Conservative management of ASBO was successful in 63.4% of patients. Clinical symptoms, physical examination, duration since surgery, and plain abdominal X-ray findings can help predict patients at risk of conservative treatment failure, supporting timely surgical intervention.