Adhesive small bowel obstruction
– The fifth Dutch Snapshot study –
PARTICIPATING CENTERS
PATIENTS
PUBLICATIONS
Background
Adhesive small bowel obstruction (ASBO) is a frequent abdominal surgical emergency and a leading cause of morbidity and mortality in emergency surgery. The aim of this study is to provide insight into the current management of ASBO and associated outcomes.
Objective
1) Provide insight into the current management of ASBO in the Netherlands
2) Determine effects of management of ASBO on patient outcomes
Study design
A nationwide prospective cross-sectional cohort study was conducted. All patients with clinical signs of ASBO admitted to participating Dutch hospitals were included during a 6 months inclusion period between April 2019 and December 2020. Ninety-day clinical outcomes were described and compared for nonoperative management (NOM) and laparoscopic and open surgery.
Study population
All adult patients who presented with a suspicion of ASBO (nausea with vomiting or absence of stools, abdominal distention, abdominal pain) were eligible. Exclusion criterium was a previously known other cause of small bowel obstruction (SBO), that is neoplasm or abdominal hernia.
Main results
In 34 participating hospitals, 510 patients were included, of whom 382 (74.9%) had a definitive diagnosis of ASBO. Initial management consisted of emergency surgery in 71 (18.6%) patients and NOM in 311 (81.4%) patients, 119 (31.1%) of whom required delayed surgery after failure of NOM. Surgical interventions started laparoscopically in 51.1%, of which 36.1% were converted to laparotomy. Intentional laparoscopy resulted in shorter hospital stays compared with open surgery (median 8.0 vs. 11.0 days; p<0.001) and comparable hospital mortality (5.2 vs. 4.3%; p=1.000). Oral water-soluble contrast use was associated with a decreased length of stay (p=0.0001). Hospital stay for surgical patients was shorter in patients who were operated on within 72 h of admission (p<0.001).
Other publications
This nationwide cross-sectional study demonstrates shorter hospital stay in ASBO patients who received water-soluble contrast, were operated within 72h of admission or were operated with minimally invasive techniques. Results may support the standardization of ASBO treatment.
Research question
In case you collaborated in this Snapshot study, you can use the collected data to answer your own research question.
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