Clinical Outcome in Acute Small Bowel Obstruction after Surgical or Conservative Management

Background: Small bowel obstruction (SBO) is characterized by a high rate of recurrence. In the present study, we aimed to compare the outcomes of patients managed either by conservative treatment or surgical operation for an episode of SBO. Methods: The outcomes of all patients hospitalized at a single center for acute SBO between 2004 and 2007 were assessed. The occurrence of recurrent hospitalization, surgery, SBO symptoms at home, and mortality was determined. Results: Among 221 patients admitted with SBO, 136 underwent a surgical procedure (surgical group) and 85 were managed conservatively (conservative group). Baseline characteristics were similar between treatment groups. The median follow-up time (interquartile range) was 4.7 (3.7-5.8) years. Nineteen patients (14.0%) of the surgical group were hospitalized for recurrent SBO versus 25 (29.4%) of the conservative group [hazard ratio (HR), 0.5; 95% CI, 0.3-0.9]. The need for a surgical management of a new SBO episode was similar between the two groups, ten patients (7.4%) in the surgical group and six patients (7.1%) in the conservative group (HR, 1.1; 95% CI, 0.4-3.1). Five-year mortality from the date of hospital discharge was not significantly different between the two groups (age- and sex-adjusted HR, 1.1; 95% CI, 0.6-2.1). A follow-up evaluation was obtained for 130 patients. Among them, 24 patients (34.8%) of the surgical group and 35 patients (57.4%) of the conservative group had recurrent SBO symptoms (odds ratio, 0.4; 95% CI, 0.2-0.8). Conclusions: The recurrence of SBO symptoms and new hospitalizations were significantly lower after surgical management of SBO compared with conservative treatment

Clinical outcome in acute small bowel obstruction after surgical or conservative management

Small bowel obstruction (SBO) is characterized by a high rate of recurrence. In the present study, we aimed to compare the outcomes of patients managed either by conservative treatment or surgical operation for an episode of SBO

Surgical management of patients with synchronous colorectal liver metastasis: a multicenter international analysis

The goal of this study was to investigate the surgical management and outcomes of patients with primary colorectal cancer (CRC) and synchronous liver metastasis (sCRLM)