Abstract text (incl. references and figure legends)
Background
Small bowel obstruction requires surgical therapy, usually in terms of adhesiolysis. In case of partial bowel ischemia, resection with anastomosis may be necessary. Morbidity and mortality associated with surgical treatment of small bowel obstruction have hardly been investigated. It is also unlcear whether 1) bowel resection and 2) timing of surgery (regular versus night-service) influence outcome.
Methods
This was a retrospective single-center evaluation. All patients with small bowel obstruction and surgical treatment of our institution from 2012-2021 were included.
Patient characteristics were compared using Kruskal-Wallis and Chi2 tests, and postoperative complications (Clavien-Dindo graduation) were compared using Mann-Whitney U and Chi2 tests.
Results
118 patients could be included in the analysis. Bowel resection was associated with a significantly increase of postoperative complications ≥ 3 according to Clavien-Dindo (50% vs. 25% without bowel resection; p = 0.005). Re-operation rate was also increased with bowel resection (43% vs. 20.8% without bowel resection; p = 0.009). No significant association between bowel resection and mortality was observed (p = 0.077). Timing of surgery had no significant (p=0.393) effect on morbidity or mortality.
Conclusion
Our results show that surgery for small bowel obstruction is associated with a significant postoperative morbidity. Bowel resection is associated with an increased rate of major complications and reoperations. Furthermore, from our data, timing of surgery (regular vs. night-service) did not influence outcome. Thus, medical urgency should be the only factor considered when scheduling surgery.
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