IS ADHESIOLYSIS TRULY EFFECTIVE FOR ADHESIVE SMALL BOWEL OBSTRUCTION? sfckubota@gmail.com

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IS ADHESIOLYSIS TRULY EFFECTIVE FOR ADHESIVE SMALL BOWEL OBSTRUCTION?

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Japan

Oral or Poster

Adhesiolysis is a common surgical procedure for adhesive small bowel obstruction (ASBO) when conservative treatment fails. However, in some cases with severe adhesions, even careful and time-consuming adhesiolysis does not lead to a smooth recovery. Patients may take a long time to resume oral intake and be discharged. Alternatively, small bowel resection and anastomosis may offer better outcomes.

We reviewed patients admitted to our department with bowel obstruction from 2012 to 2024. Among them, 365 patients were diagnosed with ASBO and received conservative treatment initially. Of these, 35 required surgery due to lack of improvement. We divided them into two groups: 21 underwent adhesiolysis (L group), and 14 underwent small bowel resection with anastomosis (R group). We compared the duration from surgery to discharge between the groups.

There were no significant differences in patient background between the two groups. The average postoperative hospital stay was 19 days in the L group and 13 days in the R group. Welch’s t-test showed a significant difference (p = 0.033), with shorter stays in the R group.

Adhesiolysis is a standard treatment for ASBO, but its effectiveness may be limited in certain cases. In selected patients, resection and anastomosis may be a better option, especially when adhesions are dense and multiple.