Early surgery for strangulated and non-strangulated small bowel obstruction has no advantages over delayed procedure, especially in elderly patients: results of a multicenter retrospective cohort study.
- 1Pirogov Medical University, Pirogov Russian National Research Medical University, Surgery - Moscow, Russia.
Abstract
Background
Adhesive small bowel obstruction (SBO) can be managed surgically or non-operatively. However, there are still no well-established criteria for defining the optimal treatment strategy. Recent evidence suggests that early intervention within 24 hours of admission to hospital may benefit patients.Methods
This was a multicenter retrospective study of adhesive SBO investigating the outcomes of early surgery (<12 hours), delayed surgery, and nonoperative treatment in 143 patients. In addition, the impact of time to surgery was also assessed in cases of strangulated and non-strangulated SBO.Results
Sixty-six (46.2%) patients underwent surgery, which was initiated laparoscopically in 49 (74.2%) cases. Of them, 36 (54.5%) patients were operated on within 12 hours of admission, and another 30 (45.5%) after 12 hours. The remaining 77 (53.5%) patients were successfully treated nonoperatively. In-hospital mortality was 7%, and all deaths (n=10; mean age 75.4 years, standard deviation±13.1 years) occurred postoperatively. Time from admission to surgery was not associated with mortality from any type of obstruction (strangulated or non-strangulated). Mortality was higher among older patients (>75 years) with non-strangulated SBO (p=0.01).Conclusions
The surgery performed in the first 12 hours of admission, whether for strangulated or non-strangulated adhesive SBO, did not show advantages over delayed surgery. A less aggressive approach to the treatment of older or frail patients would be a wiser option.
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BibTeX
@article{tyagunov2026early,
title = {{Early surgery for strangulated and non-strangulated small bowel obstruction has no advantages over delayed procedure, especially in elderly patients: results of a multicenter retrospective cohort study.}},
author = {Alexander Tyagunov and Anton Tyagunov and Taras Nechay and Kirill Melnikov-Makarchuk and Zaripat Alieva and Botan Abdulkarim and Alexander Sazhin},
journal = {Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery},
year = {2026},
month = oct,
doi = {10.1590/0102-672020260000041e1970},
url = {https://europepmc.org/article/MED/42912027},
note = {CC BY},
}
RIS
TY - JOUR
TI - Early surgery for strangulated and non-strangulated small bowel obstruction has no advantages over delayed procedure, especially in elderly patients: results of a multicenter retrospective cohort study.
AU - Alexander Tyagunov
AU - Anton Tyagunov
AU - Taras Nechay
AU - Kirill Melnikov-Makarchuk
AU - Zaripat Alieva
AU - Botan Abdulkarim
AU - Alexander Sazhin
PY - 2026
DA - 2026/10/09
JO - Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
DO - 10.1590/0102-672020260000041e1970
UR - https://europepmc.org/article/MED/42912027
AB - Background Adhesive small bowel obstruction (SBO) can be managed surgically or non-operatively. However, there are still no well-established criteria for defining the optimal treatment strategy. Recent evidence suggests that early intervention within 24 hours of admission to hospital may benefit patients.Methods This was a multicenter retrospective study of adhesive SBO investigating the outcomes of early surgery (<12 hours), delayed surgery, and nonoperative treatment in 143 patients. In addition, the impact of time to surgery was also assessed in cases of strangulated and non-strangulated SBO.Results Sixty-six (46.2%) patients underwent surgery, which was initiated laparoscopically in 49 (74.2%) cases. Of them, 36 (54.5%) patients were operated on within 12 hours of admission, and another 30 (45.5%) after 12 hours. The remaining 77 (53.5%) patients were successfully treated nonoperatively. In-hospital mortality was 7%, and all deaths (n=10; mean age 75.4 years, standard deviation±13.1 years) occurred postoperatively. Time from admission to surgery was not associated with mortality from any type of obstruction (strangulated or non-strangulated). Mortality was higher among older patients (>75 years) with non-strangulated SBO (p=0.01).Conclusions The surgery performed in the first 12 hours of admission, whether for strangulated or non-strangulated adhesive SBO, did not show advantages over delayed surgery. A less aggressive approach to the treatment of older or frail patients would be a wiser option.
SN - 0102-6720
SN - 2317-6326
ER -