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Small bowel obstruction after appendicectomy.

R E Andersson1

  • 1Department of Surgery, Ryhov Hospital, S-551 85, Jönköping, Sweden. roland.andersson@ryhov.ltjkpg.se

The British Journal of Surgery
|October 2, 2001
PubMed
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The risk of surgically treated small bowel obstruction after open appendicectomy is lower than previously believed. Key risk factors include perforated appendicitis, negative appendicectomy, and advanced age.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Epidemiology

Background:

  • Open appendicectomy is a common surgical procedure.
  • Small bowel obstruction (SBO) is a potential complication following abdominal surgery.

Purpose of the Study:

  • To analyze the long-term risk of surgically treated small bowel obstruction after open appendicectomy.
  • To identify risk factors associated with SBO post-appendicectomy.

Main Methods:

  • Historical cohort study design.
  • Involved 245,400 patients undergoing open appendicectomy and population-based matched controls.
  • Utilized life-table analysis, Kaplan-Meier plots, and Cox proportional hazards regression.

Main Results:

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  • Cumulative risk of SBO after appendicectomy was 0.41% (4 weeks), 0.63% (1 year), and 1.30% (30 years).
  • Higher risks observed for operations for other diagnoses (aHR 5.2), perforated appendicitis (aHR 3.5), and negative appendicectomy (aHR 2.6).
  • Risk was lowest in the 20-39 age group and slightly lower in women.

    • Conclusions:

    • The risk of postoperative SBO requiring surgical intervention after open appendicectomy is lower than previously estimated.
    • Perforated appendicitis, negative appendicectomy, and older age are significant risk factors for SBO.