The Safety of Expectant Management for Adhesive Small Bowel Obstruction: A Systematic Review

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Lucas W ThornbladeGiana H Davidson

Abstract

Surgical training has long been to "never let the sun set on a bowel obstruction" without an operation to rule out and/or treat compromised bowel. However, advances in diagnostics have called into question the appropriate timing of non-emergent operations and expectant management is increasingly used. We performed a systematic review to evaluate the safety and effectiveness of expectant management for adhesive small bowel obstruction (aSBO) compared to early, non-emergent operation. We queried PubMed, EMBASE, and Cochrane databases for studies (1990-present) comparing early, non-emergent operations and expectant management for aSBO (PROSPERO #CRD42017057676). Of 4873 studies, 29 cohort studies were included for full-text review. Four studies directly compared early surgery with expectant management, but none excluded patients who underwent emergent operations from those having early non-emergent surgery, precluding a direct comparison of the two treatment types of interest. When aggregated, the rate of bowel resection was 29% in patients undergoing early operation vs. 10% in those undergoing expectant management. The rate of successful, non-operative management in the expectant group was 58%. There was a 1.3-day difference in L...Continue Reading

References

Jan 1, 1993·American Journal of Surgery·D SerorH R Freund
May 1, 1993·The Australian and New Zealand Journal of Surgery·M R CoxA W Heinz
Feb 4, 1998·Journal of the American College of Surgeons·N F RayS Perry
Mar 16, 2000·The British Journal of Surgery·J G Mosley, A Shoaib
Jan 29, 2003·The European Journal of Surgery = Acta Chirurgica·B T FevangA Viste
Jul 5, 2003·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·B T FevangA Viste
May 1, 2004·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J KössiM Laato
Nov 20, 2004·ANZ Journal of Surgery·Matthew D RyanPaul Hakendorf
May 3, 2005·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Rebecca D MalloDavid R Flum
Nov 9, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Shyr-Chyr ChenWei-Jao Chen
Jul 20, 2007·The Cochrane Database of Systematic Reviews·S AbbasB R Parry
Oct 14, 2008·Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine·Xin-Zu ChenJian-Kun Hu
Jul 22, 2009·PLoS Medicine·David MoherUNKNOWN PRISMA Group
Jun 11, 2011·BMC Surgery·Vanja SikiricaAlan Johns
Aug 24, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Daniel I ChuJames M Becker
Dec 27, 2012·The Journal of Trauma and Acute Care Surgery·Adrian A MaungUNKNOWN Eastern Association for the Surgery of Trauma
Dec 29, 2012·The Journal of Trauma and Acute Care Surgery·Dean SchraufnagelFrederick Heaton Millham
Sep 12, 2013·Annals of Surgery·Pedro G TeixeiraDemetrios Demetriades
Oct 30, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mohammad A KhasawnehMartin D Zielinski
Aug 26, 2014·World Journal of Surgery·Raphael P H MeierFrank Schwenter
Nov 26, 2014·Canadian Journal of Surgery. Journal Canadien De Chirurgie·Jeremy E SpringerPaul M Johnson
Apr 1, 2011·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·K IsakssonB Tingstedt
Aug 2, 2017·ESMO Open·Andrés Cervantes
Oct 29, 2017·The Journal of Surgical Research·Lucas W ThornbladeDanielle C Lavallee
Mar 14, 2019·BJU International·Sari KhaleelPhilipp Dahm

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Citations

Oct 9, 2019·Journal of the American Medical Informatics Association : JAMIA·Nicholas J DobbinsSean D Mooney
Mar 21, 2020·The Journal of Trauma and Acute Care Surgery·Pepijn KrielenRoberto Cirocchi
Jan 30, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·M PoddaS Di Saverio
Aug 12, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·F FeuerstossAurélien Venara

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