Long-term prognosis after operation for adhesive small bowel obstruction

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Adhesive Small Bowel Obstruction

Background:

• Adhesive small bowel obstruction (ASBO) is a common complication following abdominal surgery.
• Understanding recurrence patterns and associated factors is crucial for patient management.
• Chronic abdominal pain is frequently reported by patients with a history of ASBO.

Purpose of the Study:

• To determine the recurrence rate of adhesive small bowel obstruction (ASBO) over a 40-year follow-up period.
• To identify factors influencing ASBO recurrence.
• To assess the prevalence and severity of chronic abdominal pain in ASBO patients.

Main Methods:

• Retrospective analysis of 500 patients operated on for ASBO between 1961 and 1995.
• Long-term follow-up (up to 40 years) including questionnaires for living patients.
• Statistical analysis of recurrence rates, influencing factors, and abdominal pain prevalence.

Main Results:

• Cumulative recurrence rates reached 29% at 30 years for single ASBO episodes and 81% for those with 4+ admissions.
• Recurrence risk increased with the number of prior ASBO episodes, prior abdominal surgeries, and treatment method of the last episode.
• ASBO patients experience significantly more abdominal pain than the general population, especially women and those with matted adhesions.

Conclusions:

• The number of ASBO episodes is a significant predictor of recurrence, with a considerable risk persisting for 10-20 years.
• Surgical treatment of ASBO may reduce future admissions but does not alter the risk of surgically treated recurrences.
• Adhesive small bowel obstruction patients, particularly those with matted adhesions, have a higher burden of chronic abdominal pain.