Table 4.
Demographic features and outcomes in patients treated surgically for adhesive small bowel obstruction (ASBO), based on the definitive surgical procedure.
| Definitive surgical approach | |||
|---|---|---|---|
| Laparoscopic, N=62 (32.6%) | Open, N=128 (67.4%) | P | |
| Demographics | |||
| Sex | 28 (45.2) male | 66 (51.6) male | 0.408 |
| Age (year) | 66.13 (17.33) | 69.15 (14.44) | 0.208 |
| WHO performance index | 0.660 | ||
| 0 | 25 (38.7) | 39 (30.5) | |
| 1 | 21 (33.9) | 47 (36.7) | |
| 2 | 12 (19.4) | 33 (35.8) | |
| 3 | 3 (4.8) | 8 (6.3) | |
| 4 | 1 (1.6) | 1 (0.8) | |
| ASA classification | 0.020 | ||
| 1 | 8 (12.9) | 11 (8.6) | |
| 2 | 39 (62.9) | 57 (44.5) | |
| 3 | 14 (22.6) | 51 (39.8) | |
| 4 | 1 (1.6) | 9 (7.0) | |
| Charlson score | 3 [0–10] | 3 [0–11] | 0.125 |
| 0 | 16 (25.8) | 34 (26.6) | 0.967 |
| 1 | 5 (8.1) | 12 (9.4) | |
| 2 | 11 (17.7) | 19 (14.8) | |
| 3 | 16 (25.8) | 25 (19.5) | |
| ≥4 | 14 (22.6) | 38 (29.7) | |
| Number of previous ASBO | 0.485 | ||
| 0 | 58 (93.5) | 113 (88.3) | |
| 1 | 4 (6.5) | 10 (7.8) | |
| 2 | 0 | 3 (2.3) | |
| ≥3 | 0 | 2 (1.6) | |
| ≥Operative management | 1 (1.6) | 9 (7.0) | 0.170 |
| NOM only | 3 (4.8) | 7 (5.5) | 1.000 |
| Number of previous operations | 0.136 | ||
| 0 | 16 (25.8) | 18 (14.2) | |
| 1 | 25 (40.3) | 47 (26.7) | |
| 2 | 11 (17.7) | 34 (36.6) | |
| ≥3 | 10 (16.1) | 29 (22.7) | |
| ≥1 Laparotomy | 26 (41.9) | 80 (62.5) | 0.008 |
| Laparoscopy only | 9 (14.5) | 9 (7.0) | 0.116 |
| Type of previous surgery | − | ||
| No abdominal surgery | 16 (25.8) | 18 (14.2) | |
| Cholecystectomy | 2 (3.2) | 2 (1.6) | |
| Gynecological with uterus extirpation | 4 (6.5) | 8 (6.3) | |
| Gynecological no uterus extirpation | 3 (4.8) | 8 (6.3) | |
| Liver | 0 | 0 | |
| Appendectomy | 12 (19.4) | 12 (9.4) | |
| Urological | 2 (3.2) | 7 (5.5) | |
| Upper gastrointestinal | 3 (4.8) | 3 (2.3) | |
| Retroperitoneal | 0 | 0 | |
| Other | 4 (6.5) | 37 (28.9) | |
| Colon | 13 (21.0) | 25 (19.5) | |
| Rectum | 3 (4.8) | 8 (6.3) | |
| Operative outcomes | |||
| Procedure | |||
| Adhesiolysis single adhesive band | 43 (69.4) | 73 (57.0) | – |
| Extensive adhesiolysis | 9 (14.5) | 26 (20.3) | |
| Resection and anastomosis | 4 (6.5) | 14 (10.9) | |
| Resection and stoma | – | 3 (2.3) | |
| Resection without stoma | 2 (3.2) | – | |
| Bypass | – | 1 (0.8) | |
| Other | 4 (6.5) | 11 (8.6) | |
| Duration of surgery (min) | 77.4 (41.1) | 83.7 (51.6) | 0.386 |
| Serosasal injury | 15 (24.2) | 53 (41.4) | 0.024 |
| Enterotomy | 7 (11.3) | 17 (13.2) | 0.818 |
| Outcomes | |||
| LOS (day) | 7.0 [0–28] | 10.5 [1–129] | 7.0 [0–28] |
| ICU admission | 7 (11.3) | 34 (26.6) | 0.023 |
| Duration (day) | 3 [1–12] | 1 [1–35] | 0.367 |
| In-hospital mortality | 4 (6.5) | 5 (3.9) | 0.477 |
| Readmission | 5 (8.1) | 18 (14.1) | 0.246 |
| Complications | 2 (3.2) | 13 (10.2) | 0.297 |
| Recurrence | 3 (4.8) | 5 (3.9) | |
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.