Abstract
BACKGROUND: Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO.
METHODS: We reviewed medical records including operation descriptions from patients who underwent emergency surgery due to ASBO at our institution between 2004 and 2013. Information on the peri- and postoperative periods, including conservatively and surgically treated recurrent ASBO, were obtained from medical records.
RESULTS: In total, 478 patients were included in the study. Of these, 58 (12.1%) patients experienced recurrence of ASBO during median 2.2 years follow-up. Female gender (hazard ratio [HR] 2.00, P = 0.023), multiple/matted adhesions (HR 1.72, P = 0.046), and fascial dehiscence (HR 3.26, P = 0.009) were associated with increased risk of recurrence. Conversely, intestinal resection decreased the risk of recurrence (HR 0.47, P = 0.036).
CONCLUSIONS: The overall recurrence rate after surgically treated ASBO was 12.1%, and the risk of recurrence was persistent several years after index operation. Factors associated with an increased risk were female gender, multiple/matted adhesions, and fascial dehiscence.
| Original language | English |
|---|---|
| Journal | Journal of Gastrointestinal Surgery |
| Volume | 22 |
| Issue number | 2 |
| Pages (from-to) | 329-334 |
| ISSN | 1091-255X |
| DOIs | |
| Publication status | Published - 1 Feb 2018 |
Keywords
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Female
- Follow-Up Studies
- Humans
- Intestinal Obstruction/etiology
- Intestine, Small
- Male
- Middle Aged
- Proportional Hazards Models
- Recurrence
- Risk Factors
- Sex Factors
- Tissue Adhesions/complications
- Young Adult