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Long-term outcome after hospitalization for small-bowel obstruction
J Landercasper1, T H Cogbill, W H Merry
1Department of Surgery, Gundersen/Lutheran Medical Center, La Crosse, WI.
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1993
Summary
The long-term risk of recurrent small-bowel obstruction is high, with 42% of patients experiencing it within 10 years. Surgery reduces this risk, but most recurrences happen within 4 years.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Epidemiology
Background:
- Small-bowel obstruction (SBO) is a common surgical emergency.
- Understanding recurrence patterns is crucial for patient management and prognosis.
Purpose of the Study:
- To determine the recurrence rate of mechanical small-bowel obstruction.
- To analyze differences in recurrence rates based on the cause of obstruction and treatment method.
Main Methods:
- Retrospective chart review of 309 patients hospitalized for SBO between 1981 and 1986.
- Actuarial life-table method used for recurrence rate calculation.
- Wilcoxon and log-rank tests for statistical comparisons.
Main Results:
- Overall recurrence rate reached 34% by 4 years and 42% by 10 years.
- Patients undergoing surgery had a lower recurrence rate (29%) compared to non-surgical patients (53%) (P = .002).
- Recurrence rates after surgery varied by cause: 56% for neoplasms, 28% for adhesions, and 0% for hernias.
Conclusions:
- A significant long-term risk of recurrent small-bowel obstruction exists.
- Surgical intervention lowers, but does not eliminate, the risk of recurrence.
- Most recurrences occur within 4 years, and prior multiple obstructions did not significantly increase future risk.