| Autor: |
E. Ortolano, C. Maina, A. D'Addiego, C. Ciuffa, S.I. Rocchetti, A.A. Beneduce, M. Carlucci |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
Surgery in Practice and Science, Vol 14, Iss , Pp 100213- (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2666-2620 |
| DOI: |
10.1016/j.sipas.2023.100213 |
| Popis: |
Background: Acute small bowel obstruction (aSBO) is the most common cause (76%) of acute intestinal obstruction. Laparoscopy use is still controversial in aSBO and indications not yet clearly defined. The aim of this study was to demonstrate the effectiveness and safety of a laparoscopic approach in aSBO by using specific pre-operative criteria for appropriate patient selection. Methods: We retrospectively analyzed medical records of patients accepted at the Emergency Department for aSBO between January 2016 and March 2021 and performed a comparative analysis between types of treatment, considering demographics, clinical and radiological presentation, non-operative vs. operative management, intraoperative outcome, and postoperative course. We used a logistic regression to identify the variables related to surgical approach and built a predictive score upon the multivariable predictive model: the “SABO score”. Results: 198 patients were included in the study, of which 145 underwent surgery and 43 were successfully treated laparoscopically. Age and comorbidities were associated with open surgery (OR 3.2, 95% CI: 1.4–7.2, p = 0.006 and OR 2.7, 95% CI: 1.1–6.5, p = 0.023). A SABO score ≥ 0 identified an open approach with a sensitivity of 75.4% and a specificity of 69.8%. Conclusions: Laparoscopy is growing in importance even in emergency settings. Our analysis suggests that a laparoscopic approach can be safe and feasible in aSBO management. Correct patient selection appears to be the key for a successful minimally invasive approach. SABO score therefore could be helpful in choosing the correct surgical strategy for patients with aSBO. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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