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Research Article Open access CC BY 4.0

Challenges of Malignant Small Bowel Obstruction – Results of a State Surgical Mortality Dataset

Skyle Murphy, Arkadiusz Peter Wysocki, Jennifer Allen, Therese Rey-Conde, John B. North

Journal of Advances in Medicine and Medical Research · pp. 1–8 · Published 20 May 2016

10.9734/BJMMR/2016/26388

Abstract

Background: Small bowel obstruction is a common acute surgical pathology. Despite the substantial postoperative mortality associated with small bowel obstruction (SBO), there is limited evidence to support clinical decision-making. The purpose of this study was to identify differences in system, patient and operative features in adults who died following operative treatment of malignant versus nonmalignant small bowel obstruction. Methods: Retrospective analysis of adults with SBO who died in hospital while under the care of a surgeon. Data was collected by the Australian and New Zealand Audit of Surgical Mortality from Queensland hospitals between January 2009 and December 2014. Results: 523 patients died post-operatively following surgical treatment of small bowel obstruction over the six-year study period. The most common etiologies were adhesive (41%), malignancy (25%) and hernia (16%). Compared to those with a nonmalignant etiology, patients with malignant SBO were younger (P < 0.001) but had a longer mean pre-operative inpatient admission (P = 0.007), and were more likely to require an anastomosis at the time of operation (P < 0.001). Conclusion: Despite being younger, patients with malignant small bowel obstruction are challenging to manage. Further studies are needed to help surgeons manage patients with malignant small bowel obstruction.

Small bowel obstruction mortality audit laparotomy

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