Is Exploratory Laparoscopy the Optimal Surgical Strategy for Small Bowel Obstruction? A Single-Center Retrospective...

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Outcomes Research

Background:

• Optimal surgical strategy for small bowel obstruction (SBO) remains debated.
• Laparoscopic surgery (LS) presents a potential alternative to open surgery (OS).

Purpose of the Study:

• To compare the feasibility and outcomes of LS versus OS for SBO.
• To identify risk factors and develop a predictive model for conversion to open surgery (OCS).

Main Methods:

• Retrospective analysis of 303 SBO patients.
• Propensity score matching comparing 233 LS patients (including 43 OCS) with 70 OS patients.
• Investigation of independent risk factors for OCS.

Main Results:

• LS group showed significantly less hemorrhage, fewer severe complications, and shorter hospital stays than OS group.
• Recurrence rates were similar between LS and OS.
• Outcomes for OCS were inferior to completed LS and comparable to OS.
• Independent risk factors for OCS included prior abdominal surgery, low albumin, low platelets, and high neutrophil-to-lymphocyte ratio.

Conclusions:

• Laparoscopic surgery (LS) for SBO demonstrates superior outcomes compared to open surgery (OS).
• Exploratory laparoscopy should be considered the primary approach for SBO, irrespective of predicted OCS risk.