Table 3.
Demographic features and outcomes in patients treated surgically for adhesive small bowel obstruction (ASBO), based on the initial surgical approach.
| Initial surgical approach | ||||
|---|---|---|---|---|
| Laparoscopic, N=97 (51.1%) | Open, N=93 (48.9%) | P | Conversion, N=35 (36.1%) | |
| Demographics | ||||
| Sex | 47 (48.5) male | 47 (50.5) male | 0.774 | 19 (54.3) male |
| Age (year) | 67.96 (15.82) | 68.38 (15.16) | 0.702 | 71.20 (12.29) |
| WHO performance index | 0.390 | |||
| 0 | 37 (38.1) | 26 (28.0) | 13 (37.1) | |
| 1 | 35 (36.1) | 33 (35.5) | 14 (40.0) | |
| 2 | 18 (18.6) | 27 (29.0) | 6 (17.1) | |
| 3 | 5 (5.1) | 5 (6.5) | 2 (5.7) | |
| 4 | 1 (1.0) | 1 (1.1) | - | |
| ASA classification | 0.003 | |||
| 1 | 13 (13.4) | 6 (6.5) | 5 (14.3) | |
| 2 | 58 (59.8) | 38 (40.9) | 19 (54.3) | |
| 3 | 23 (23.7) | 42 (45.2) | 9 (25.7) | |
| 4 | 3 (3.1) | 7 (7.5) | 2 (5.7) | |
| Charlson score | 3 [0–10] | 3 [0–11] | 0.172 | 3 [0–9] |
| 0 | 24 (24.7) | 29 (31.2) | 0.576 | 8 (22.9) |
| 1 | 9 (9.3) | 8 (8.6) | 4 (11.4) | |
| 2 | 16 (16.5) | 16 (17.2) | 5 (14.3) | |
| 3 | 26 (26.8) | 16 (17.2) | 10 (28.6) | |
| ≥4 | 22 (22.7) | 24 (25.8) | 8 (22.9) | |
| Number of previous ASBO | ||||
| 0 | 87 (89.7) | 84 (90.3) | 0.880 | 29 (82.9) |
| 1 | 8 (8.2) | 6 (6.5) | 1.000 | 4 (11.4) |
| 2 | 1 (1.0) | 2 (2.2) | 1.000 | 1 (2.9) |
| ≥3 | 1 (1.0) | 1 (1.1) | 1 (2.9) | |
| ≥Operative management | 5 (5.2) | 5 (5.4) | 4 (11.4) | |
| NOM only | 5 (5.2) | 5 (5.4) | 2 (5.7) | |
| Number of previous operations | 0.031 | |||
| 0 | 25 (24.7) | 10 (10.8) | 8 (22.9) | |
| 1 | 37 (38.1) | 35 (37.6) | 12 (34.3) | |
| 2 | 22 (22.7) | 23 (24.7) | 11 (31.4) | |
| ≥3 | 14 (14.4) | 25 (26.9) | 4 (11.4) | |
| ≥1 Laparotomy | 39 (40.2) | 67 (72.0) | 0.000 | 13 (37.1) |
| Laparoscopy only | 13 (13.4) | 5 (5.4) | 0.082 | 4 (11.4) |
| Type of previous surgery | ||||
| No abdominal surgery | 24 (24.7) | 10 (10.8) | 8 (22.9) | |
| Cholecystectomy | 3 (3.1) | 1 (1.1) | 1 (2.9) | |
| Gynecological with uterus extirpation | 5 (5.2) | 7 (7.5) | 1 (2.9) | |
| Gynecological no uterus extirpation | 6 (6.2) | 5 (5.4) | 3 (8.6) | |
| Liver | 0 | 0 | 0 | |
| Appendectomy | 16 (16.5) | 8 (8.6) | 4 (11.4) | |
| Urological | 2 (2.1) | 7 (7.5) | 0 | |
| Upper gastrointestinal | 4 (4.1) | 2 (2.2) | 1 (2.9) | |
| Retroperitoneal | 0 | 0 | 0 | |
| Other | 15 (15.5) | 26 (28.0) | 11 (31.4) | |
| Colon | 18 (18.6) | 20 (21.5) | 5 (14.3) | |
| Rectum | 4 (4.2) | 7 (7.5) | 1 (2.9) | |
| Operative outcomes | ||||
| Procedure | – | |||
| Adhesiolysis single adhesive band | 65 (67.0) | 51 (54.8) | 22 (62.0) | |
| Extensive adhesiolysis | 16 (16.5) | 19 (20.4) | 7 (20.0) | |
| Resection and anastomosis | 9 (9.3) | 9 (9.7) | 5 (14.3) | |
| Resection and stoma | – | 3 (3.2) | – | |
| Resection without stoma | 2 (2.1) | – | – | |
| Bypass | 2 (2.1) | 1 (1.1) | – | |
| Other | 5 (5.2) | 10 (10.8) | 1 (2.9) | |
| Duration of surgery (min) | 80.83 (45.2) | 82.52 (51.74) | 0.903 | 86.9 (51.68) |
| Serosasal injury | 29 (29.9) | 39 (41.9) | 0.084 | 14 (40.0) |
| Enterotomy | 13 (13.4) | 11 (11.8) | 0.744 | 6 (17.1) |
| Outcomes | ||||
| LOS (day) | 8.00 [0–109] | 11.00[1–129] | 0.000 | 9.00 [3–109] |
| ICU admission | 17 (17.5) | 24 (25.8) | 0.165 | 10 (28.6) |
| Duration (day) | 2.00 [1–35] | 1.00 [1–7] | 0.032 | 2.00 [1–35] |
| In-hospital mortality | 5 (5.2) | 4 (4.3) | 1.000 | 1 (2.9) |
| Readmission | 8 (8.2) | 15 (16.1) | 0.118 | 3 (8.6) |
| Complications | 3 (3.1) | 12 (12.9) | 0.071 | 1 (2.9) |
| Recurrence | 5 (5.2) | 3 (3.2) | 2 (5.7) | |
ASA, American Society of Anesthesiologists physical status classification; ASBO, adhesive small bowel obstruction; GE, gastroenterology; IC, intensive care; LOS, length of stay; NOM, nonoperative management; WHO, World Health Organization.