Type of Prior Operation Does Not Predict Surgical Intervention for Small Bowel Obstruction

Abstract

Background: Patients with prior abdominal surgeries are at higher risk for intra-abdominal adhesive tissue formation and subsequently higher risk for small bowel obstruction (SBO). Purpose: In this study, we investigated whether surgical intervention for SBO was more likely following specific types of abdominal surgeries. Research Design: With retrospective chart review, we pooled data from 799 patients, ages 18 to 89, admitted with SBO between 2012 and 2019. Patients were evaluated based on whether they underwent surgery or were managed conservatively. They were further compared with regard to past surgical history by way of type of abdominal surgery (or surgeries) undergone prior to admission. Results: Of the 799 patients admitted for SBO, 206 underwent surgical intervention while 593 were managed nonoperatively. There was no significant difference in number of prior surgeries (2.07 ± 1.56 vs 2.36 ± 2.11,  P = .07) or in number of comorbidities (2.39 ± 1.97 vs 2.65 ± 1.93,  P = .09) for surgical vs non-surgical intervention. Additionally, of the operations evaluated, no specific type of abdominal surgery predicted need for surgical intervention in the setting of SBO. However, for both surgical and non-surgical intervention following SBO, pelvic surgery was the most common type of prior abdominal surgery (45% vs 43%). There are significantly more female pelvic surgeries in both the operative (91.4% vs 8.6%,  P < .0001) and nonoperative groups (89.9% vs 10.2%,  P < .0001). Conclusion: Ultimately, no specific type of prior operation predicted the need for surgical intervention in the setting of SBO.