Impact of Protocol Utilizing Water-Soluble Contrast for Adhesive Small Bowel Obstruction
Autor: | Danielle A. Pigneri, Brandon Bullock, Jason Granet, Robert Behm, Luke Dombert, Xujun Liu, Addison K. May, Trey Mathews, Amber Hussain, Patrick Faughnan, Kristy Semenza |
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Rok vydání: | 2021 |
Předmět: |
Decompression
Male medicine.medical_specialty Bowel ischemia medicine.medical_treatment Contrast Media Tissue Adhesions Time-to-Treatment 03 medical and health sciences Patient Admission 0302 clinical medicine Clinical Protocols Ischemia Intestine Small medicine Humans Statistical analysis Watchful Waiting Intubation Gastrointestinal Aged Retrospective Studies Aged 80 and over Retrospective review business.industry Incidence Incidence (epidemiology) Water Length of Stay Middle Aged medicine.disease Surgery Bowel obstruction Treatment Outcome Water soluble Solubility 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business Intestinal Obstruction Watchful waiting |
Zdroj: | Journal of Surgical Research. 259:487-492 |
ISSN: | 0022-4804 |
Popis: | Adhesive small bowel obstruction (ASBO) has classically been managed with nasogastric tube decompression and watchful waiting. Our group developed an evidence-based protocol to manage ASBO utilizing a water-soluble contrast (WSC) agent. We hypothesized the protocol would decrease the length of stay (LOS) for patients admitted with ASBO along with the time interval from admission to surgery.From 2010 to 2018, a retrospective review was performed, including all patients admitted with a diagnosis of ASBO. These patients were divided into two groups: the preprotocol group included years 2010-2013 and the postprotocol group included years 2015-2018. A Student t-test and a two-proportion z-test were used for statistical analysis.We captured 767 patients; 296 in the preprotocol group and 471 in the postprotocol group. We found a significant decrease in overall LOS between the preprotocol and postprotocol groups (6.56 d versus 4.08 d; P 0.001) along with decreases in LOS for patients managed nonoperatively (5.36 d versus 3.42 d; P 0.001) and operatively (16.09 d versus 9.47 d; P 0.001). Time interval from admission to the operation was significantly decreased in the postprotocol group (3.79 d versus 2.10 d; P 0.050). We identified a trend toward decreased rates of bowel ischemia and resections with our protocol.These results reaffirm previous reports of WSC's impact on overall LOS in ASBO while showing a similar impact on both operative and nonoperative groups. The decreased time interval between admission and operation may impact the incidence of bowel ischemia and resections. |
Databáze: | OpenAIRE |
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