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Non-operative management of small bowel obstruction in virgin abdomen: a systematic review.
- Source :
-
Surgery today [Surg Today] 2021 Oct; Vol. 51 (10), pp. 1558-1567. Date of Electronic Publication: 2021 Jan 22. - Publication Year :
- 2021
-
Abstract
- The aim of this study was to systematically review the feasibility and safety of non-operative management of small bowel obstruction (SBO) in virgin abdomen. A systematic review was performed through December 2019. The primary outcome was the resolution of non-operative management of SBO in virgin abdomen. Secondary outcomes were the etiology of SBO and findings of exploratory laparotomy. Six studies were included in the analysis. Of the 442 patients, 2 with metastatic cancer received palliative care, and the management in 26 was not reported, so these patients were excluded. A total of 414 patients were ultimately analyzed, including 203 patients (49%) who were managed non-operatively and 211 (51%) who underwent surgical management. Of the 203 managed non-operatively, the condition of 194 (96%) was resolved without further intervention. The remaining 9 (5%) patients failed non-operative management and ultimately required surgery. Of the 211 patients who underwent surgical exploration, only 137 had their intraoperative findings reported. Adhesions (n = 67; 49%) were the main cause, followed by malignancy (n = 14; 10%) and others (n = 33; 24%). No cause was found in 23 patients (17%). In highly select cases of SBO with virgin abdomen, non-operative management can be attempted if patients are clinically stable and computed tomography does not demonstrate concerning features or obvious pathology. Further well-designed prospective studies will be required prior to the introduction of this concept in clinical practice, as current evidence remains heterogeneous.<br /> (© 2021. Springer Nature Singapore Pte Ltd.)
- Subjects :
- Conservative Treatment statistics & numerical data
Digestive System Surgical Procedures statistics & numerical data
Feasibility Studies
Female
Humans
Intestinal Obstruction diagnostic imaging
Intestinal Obstruction etiology
Laparotomy
Magnetic Resonance Imaging
Male
Safety
Tomography, X-Ray Computed
Treatment Outcome
Conservative Treatment methods
Intestinal Obstruction therapy
Intestine, Small
Subjects
Details
- Language :
- English
- ISSN :
- 1436-2813
- Volume :
- 51
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Surgery today
- Publication Type :
- Academic Journal
- Accession number :
- 33481087
- Full Text :
- https://doi.org/10.1007/s00595-020-02210-4