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Published on: August 22, 2025

Predictive value of gastrointestinal decompression volume and its trajectory over time for surgical intervention in

Zhi Yi Niu1, Qian Yun Wu1, Yu Zuo Bai1

  • 1Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Annals of Medicine
|June 29, 2026
PubMed

Insights

Early gastrointestinal decompression volume trends can predict surgical intervention needs in pediatric postoperative adhesive small bowel obstruction (ASBO). A rapid decrease suggests successful conservative treatment, while a slower decline indicates potential need for surgery.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Surgical Outcomes

Background:

  • Adhesive small bowel obstruction (ASBO) is a common complication after abdominal surgery in children.
  • Predicting the need for surgical intervention in pediatric ASBO is crucial for timely management.
  • Conservative treatment involving gastrointestinal decompression is often the initial approach.

Purpose of the Study:

  • To evaluate the predictive value of gastrointestinal decompression volume and its temporal trends for surgical intervention in pediatric postoperative ASBO.
  • To identify early indicators for surgical necessity in children with ASBO undergoing conservative management.

Main Methods:

  • Retrospective study of 131 children with postoperative ASBO treated conservatively.
  • Analysis of daily unit weight gastrointestinal decompression volume (mL/kg) and its changes.
  • Generalized estimating equations (GEEs) for dynamic trend analysis.
  • Logistic regression and ROC curve analyses for predictive performance evaluation.

Main Results:

  • A significant interaction between time and treatment group was observed (p=0.049).
  • The successful conservative treatment group showed a rapid decrease in decompression volume (p<0.001), unlike the surgical group.
  • Higher decompression volumes from Days 1-3 were noted in the surgical group.
  • Decompression volumes on Days 1 and 2 were significant predictors of surgery (AUC 0.705-0.718).

Conclusions:

  • Unit weight gastrointestinal decompression volume and its trend are valuable predictors for surgical intervention in pediatric postoperative ASBO.
  • Early monitoring of decompression volume can aid in clinical decision-making for surgical versus conservative management.
Abstract

Keywords:
Adhesive small bowel obstructionconservative treatmentgastrointestinal decompression volumepediatric

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