• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Laparoscopic Versus Open Surgical Management of Small Bowel Obstruction – A Comparison of Outcomes

James P Byrne, BScEng, MD, Fady Saleh, MD, MPH, FRCSC, Luciano Ambrosini, MD, Carolina Jimenez, MD, Joshua Gnanasegaram, Fayez Quereshy, MD, MBA, FRCSC, Timothy D Jackson, MD, MPH, FRCSC, Allan Okrainec, MDCM, MHPE, FACS, FRCSC. Division of General Surgery, University Health Network, University of Toronto.

As the laparoscopic management of acute small bowel obstruction (SBO) grows as a tool in the armamentarium of the acute care surgeon, it is critical that outcomes are tracked to aid surgeons in making evidence-based decisions with regards to management of their patients. The purpose of this study was to review outcomes in patients with SBO treated laparoscopically compared to those treated by open surgery.

We performed a retrospective review of all patients managed surgically for small bowel obstruction at our institution from 2009 to 2012. Data abstracted included pre-operative patient characteristics and investigations. Outcomes collected included details of postoperative recovery, length of stay (LOS), morbidity and mortality. The laparoscopic group included all cases started as such, regardless of conversion. Continuous variables were compared using Student’s t-test, while categorical variables with the Chi-square test. Univariate and multivariate analysis provided a comparison of the incidence of complications between both groups, while multivariable logistical regression was performed to assess predictors of adverse outcome.

A total of 246 patients were managed surgically for acute small bowel obstruction during this period. 83 patients were treated with laparoscopy, while 163 had conventional open surgery. The most common etiology found at surgery was adhesive (63%). Mean operative time was not significantly different between laparoscopic and open surgery groups (143.0 vs. 151.0 minutes, p=0.362). There was however a significant reduction in time to recovery of bowel function in the laparoscopic group as indicated by passage of flatus (3.0 vs. 4.0 days, p=0.017), as was there in median length of stay (5 vs. 8 days, p<0.001). Overall complication rate was significantly lower in those treated with laparoscopic surgery (30.1% vs. 45.4%, p=0.021), with associated reduction in the odds of an adverse event through multivariable logistical regression (OR 0.50, 95%CI 0.28 – 0.91, p=0.024).

Treatment of patients with small bowel obstruction by an initial laparoscopic approach is safe, associated with quicker recovery, reduced length of stay, and a reduction in adverse outcome as compared to conventional open management. Further research is needed to understand predictors of successful laparoscopic completion.
 

Complications in Laparoscopic vs. Open Surgery for SBO: Univariate Analysis
Complication Open, n (%) Laparoscopic, n (%) OR (95% CI) P-value
Surgical site infection  39 (23.9)  14 (16.9)  0.65 (0.30-1.32)  0.203
Early reoperation  9 (5.5)  4 (4.8)  0.87 (0.19-3.22)  0.816
Death  16 (9.8)  3 (3.6)  0.34 (0.06-1.26)  0.085
Major complications 41 (25.2)   12 (14.5)  0.50 (0.23-1.06)  0.054
 Any Complication  74 (45.4)  25 (30.1)  0.52 (0.28-0.95)  0.021

 

Predictors of Adverse Outcome: Multivariable Logistic Regression Analysis
Variable Odds Ratio 95% CI P-value
Laparoscopic vs. Open Approach 0.50 0.28-0.91 0.024
Age 1.03 1.01-1.05 0.003
ASA* 1.69 0.57-5.02 0.348
Male 1.34 0.77-2.32 0.298
Previous abdominal surgery 0.86 0.45-1.63 0.650
Hypertension 0.85 0.45-1.57 0.595
Diabetes mellitus 1.10 0.52-2.29 0.806
Cardiac disease 1.43 0.76-2.68 0.267

*ASA 3-5 compared to 1-2

4,294

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2014 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons