Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes - 08/11/22
, Carlo Alberto Schena a, Fausto Rosa a, b, Roberta Menghi a, b, Luigi Carbone c, Andrea Piccioni c, Francesco Franceschi b, c, Sergio Alfieri a, bAbstract |
Background |
Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients.
Methods |
One-hundred-twenty-eight patients aged 65–79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65–79 years and those over 80 years.
Results |
Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU)admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery.
Conclusions |
NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | The correct management of ASBO in the elderly is still unknown. |
• | Upfront surgery in over 80 years patients relates with worse outcomes. |
• | Conservative management in octogenarians is safe and feasible. |
• | Failure of the conservative management in over 80 years patients do not lead to worse outcomes than upfront surgery. |
Keywords : Adhesive small bowel obstruction, elderly, Octogenarians, Outcomes
Mappa
Vol 224 - N° 5
P. 1209-1214 - novembre 2022 Ritorno al numero
Articolo precedente
- Small bowel obstruction: Be careful while you wait
- Michael E. Zenilman
- Gender equity in surgical literature authorship: Are we there yet?
- Shannon Jordan, Juliet Emamaullee
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?