Adhesive small bowel obstruction

Adhesive small bowel obstruction

– The fifth Dutch Snapshot study –

PATIENTS

6th of August 2020

PARTICIPATING CENTERS

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Background

Adhesive small bowel obstruction is one of the most common indications for emergency abdominal surgery.1, 2 Most of these adhesions have developed after previous elective surgery. Over 1 in 5 patients undergoing abdominal surgery experiences at least 1 episode of ASBO in the 10 years following initial operation.3 Mean length of hospital stay for an episode of ASBO is 8 days, in-hospital mortality rates are up to 2.5%.4 Despite the high incidence and morbidity of ASBO, diagnosis and treatment of an episode of ASBO varies greatly between hospitals and even between doctors. Until now, optimal treatment patterns are unknown.

Objective

The objective of this study is to analyze practice variation in diagnosis and treatment in all patients admitted with suspected ASBO. The collected data will be used to generate new hypothesis on the optimal ideal diagnostic and therapeutic workflow based on best practices, and development of guidelines.

Study design

Prospective data registration of patients with a suspicion of ASBO.

Study population

All patients with a suspicion of ASBO, older than 17 years, can be included in the present snapshot study. This includes patients directly admitted for the surgery department, or patients admitted to other departments in which a surgical consultation is requested. Patients with an episode of small bowel obstruction with a definitive diagnosis other than adhesions fall outside of the scope of this study (eg. tumor as cause of SBO); patients with uncertain cause of bowel obstruction in which adhesions are considered in differential diagnosis are eligible.

Main outcomes

Results from mapping of practice variation in diagnosis and treatment of a patient with an episode of ASBO. The final aim is to optimize care for all patients with a diagnosis of ASBO.

Planning

o All Dutch hospitals are approached to participate in the nationwide snapshot study for ASBO. The first hospitals have started including patients, all participating hospitals will start between the 1st of May and the 1st of December 2019. For a period of 6 months patients will be included in the study. First results of this study are anticipated in July 2020.

Research question

As soon as the database is complete and cleaned, a meeting will be organised for all DSRG collaborators who contributed to the data collection. At this meeting, the DSRG collaborators are invited to present their ideas for the use of the database for answering new research questions.

Other projects

Six other projects are performed by the Dutch Snapshot Research Group.

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