Accès ouvert déclaré2025article
Small bowel obstruction outcomes according to compliance with the World Society of Emergency Surgery Bologna guidelines
Lewis J. Kaplan, Isidro Martínez-Casas, Shahin Mohseni, Matteo Cimino, Hayato Kurihara, Matthew J. Lee, Gary Alan Bass, Agron Dogjani, Kastriot Subashi, Klevis Doci, Joana Spaho, Ali Hasan Abdulla, Sara Ahmed, Yusuf Al-Ansari, Mariam AlKooheji, Alaa Marzooq, Khaled Nazzal, Emir Ahmetašević, Zlatan Mehmedović, Maja Kovačević, Jasminka Mujkanović, Peter Svenningsen, G Olsen, Abeer Aboalazayem, M. Awad, Mahmoud Elfiky, M. Farouk, Mostafa Gad, Basma Magdy, Peep Talving, Edgar Lipping, Sten Saar, Artjom Bahhir, Maarja Talviste, Vincent Dubuisson, Luca Cigagna, Luigi Cayre, Spyridon Christodoulou, Panagiotis Kokoropoulos, Ioannis Margaris, Maria Papadoliopoulou, Theodoros Sidiropoulos, Pantelis Vassiliu, Evangelos Barkolias, Pavlos Georgalis, Theodosios Kantas, Vasiliki Nikolaou, Aristeidis Papadopoulos, Katerina Tata, Stergios Arapoglou, Ioannis Gkoutziotis, Aikaterini Mpratko, Elissavet Symeonidou, Stylianos Kykalos, Nikolaos Machairas, Adam Mylonakis, Panagiotis Sakarellos, Dimitrios Schizas, Michail Vailas, Iraklis Anastasiadis, Parmenion Patias, Koumarelas Konstantinos, Mourtarakos Saradis, Charles Lee, Chloe Spillane, Dylan Viani Walsh, Nadia Walsh, T. N. Walsh, Gabriel Orsi, Andrew Keane, David Kearney, Emma de Sousa, Michael Sugrue, Robert Fitzsimmons, Angus Lloyd, Muhammad Qasim, Taylor Jacoby, Michael Kelly, Shafagh Khodadi, Paul McCormick, Éanna J. Ryan, Mohamed Salama, Helen Heneghan, Cian Davis, Odhran K. Ryan, Seán Martin, Miklosh Bala, Michele Altomare, Stefano Piero Bernardo Cioffi, Andrea Spota, Giada Panagini, Laura Benuzzi, Stefania Cimbanassi, Noemi DiFuccia, S Manfroni, Alan Biloslavo, Paola Germani, Nicolò de Manzini, Manuela Mastronardi, A Modica, Serena Scomersi, Gabriele Bellio, Gaia Altieri, Pietro Fransvea, Gabriele Sganga, Silvia Tedesco, Francesca Margherita Bunino, Sabrina Caspani, Daniele DelFabbro, Simone Giudici, Giulia Mauri, Paolo Enrico Meneghesso, Enrico Ortolano, Antonella D’addiego, Francesca Di Vittorio, Gabriele Bormolini, Michele Carlucci, Giovanni Pesenti, C. Tintori, Mauro Zago, Martina Zambon, Simona Meneghini, Andrea Mingoli, Giulia Duranti, Gioia Brachini, Pierfrancesco Lapolla, Andrea Alfredo Huerta de León, Pasquale de Jesús Cristiano Nakhal, Jose Ruiz, Sergio Hernández-Jiménez, Ademola Adeyeye, Ehis Afeikhena, Akinola Akinmade, Babatunde Mustapha, J Presl, Patrick Rebnegger, Bjoern Rudisch, Gruenfelder Johanna, Rokitte Karin, Jorge A. Pereira, João Luís Alves Pinheiro, Daniel Pinto, Andreia J. Santos, Andreia Silva, Susana Henriques, João Melo, António Miguel Pereira, Bruno Dias Couto, Bárbara Gama, Catarina Santos Rodrigues, Mara Nunes, Beatriz Soares Fagundes e Silva, Daniela Tavares, Toma Mihai, Oprea C Valentin, Srdjan Putnik, Petar Andjic, Marija Djujic, Rastislav Filko, Vanja Kunkin, Andjela Milak, Aleksandar Ognjenovic, Nebojša Mitrović, Goran Aleksandric, Mihailo Bezmarević, Saša Dragović, Milan Jovanović, Boško Milev, Miroslav Mitrović, Sandra Petković, Valentina Isakovic, Nikola Nikolić, Predrag Radic, Dragan Vasić, Zlatibor Lončar, Dušan Micić, Vladimir Resanović, Pavle D Vladimir, Krstina S Doklestic Vasiljev, Ljiljana Milić, V Cuk, Jovan Juloski, Radisav Slavoljub Radulovic, Dragana Arbutina, Jacobo Trébol, Manuel José Torres-Jurado, Andres J Valera-Montiel, Francisco Blanco‐Antona, Beatriz De Andrés-Asenjo, M. Ruiz-Soriano, T. Gómez-Sanz, Andrea Vázquez-Fernández, Juan Beltrán de Heredia, Cristina Rey Valcárcel, Monica Ballón-Bordon, María Dolores Pérez-Díaz, María Sánchez‐Rodríguez, Jose David Gonzalez-Esteban, Celia Alegre Nevado, Ricardo Montenegro Romero, Andrea Campos-Serra, Raquel Gràcia-Roman, Heura Llaquet Bayo, Anna Muñoz-Campaña, Giulia Vitiello, Lorena Apodaca Murguiondo, Iñigo Augusto Ponce, Aintzane Lizarazu, Elena Sagarra Cebolla, Mónica García Aparicio, Paloma Garaulet González, B Martínez, Miriam Fraile Vasallo, Mónica Mengual-Ballester, Isabel Andrés Lucas Zamorano, Manuel Ríos Ruiz, C. Morcillo, Alberto Díaz García, Hanna Hernández Oaknin, Jennifer Amparo García Niebla, Antonio Pérez Álvarez, Diego Cordova, Laura Jiménez, Cristina Vera, Alberto Vilar Tabanera, M.D.L.A. Gil-Olarte Marquez, José Antonio López-Ruiz, Ma Estela Romero-Vargas, Julio Reguera-Rosal, Alberto Luis García García, B Marenco de la Cuadra, Eduardo Perea del Pozo, Vilma E. Muñoz, Felipe Pareja-Ciuró, Ainoa Benavides dos Santos, Ernest Bombuy, Anna G-Monferrer, Sandra López Gordo, José Guerra, Vanessa Sojo, Ana María González-Castillo, Elena Manzo, Estela Membrilla-Fernández, Amalia Pelegrina-Manzano, Simone Cremona, Alexander Forero-Torres, Santiago Valderrábano, Francisco Reinoso Olmedo, Fuad López Fernández, Aitor Landaluce-Olavarria, Jon Barrutia- Leonardo, Alba Garcia-Trancho, Melania Gonzalez-De Miguel, Izaskun Markinez‐Gordobil, Maryam Makki, Dana Altamimi, Olga Rutka, John V. Taylor, Mark Denton, Stavros Gourgiotis, Alexander Ribbits, Jared M. Wohlgemut, Christopher Leiberman, Sabreen Elbakri, Conor Magee, Oluwaseun Oyekan, Mehwish Ansar, Jeremy Wilson, Rahel Rashid, Daisy Atwell, Joshua Cassedy, William S. Hoff, Shyam Murali, Anna E. Garcia Whitlock, Carolyn Susman, Sarah Barnett, Emily Ertmann, C Desanctis, Nathan J. Klingensmith, Dale Butler, Brandon Bruns, Ankeeta Mehta, Vanessa Nomellini, Anthony Tannous
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Résumé fourni par la source
BACKGROUND: Small bowel obstruction (SBO) is a common surgical emergency associated with substantial morbidity, hospital length of stay (LOS), and healthcare cost. The World Society of Emergency Surgery (WSES) Bologna guidelines provide evidence-informed recommendations for managing adhesive SBO, promoting timely surgical intervention (or non-operative management (NOM) when ischaemia, strangulation, or peritonitis are absent). However, guideline adoption and its impact on outcomes remain under studied. Compliance with the Bologna guidelines was evaluated to determine the impact of compliance on outcomes. METHODS: SnapSBO, a prospective, multicentre, time-bound, observational cohort study, captured data on patients with adhesive SBO across diverse healthcare settings and patient populations. Patient care was categorized into: successful NOM, surgery after an unsuccessful appropriate trial of NOM (NOM-T), and direct to surgery (DTS). Compliance with diagnostic, therapeutic, and postoperative Bologna guideline recommendations was assessed as either complete or partial. Primary outcomes included adherence to the Bologna guidelines, LOS, complications, and the incidence of the composite metric 'optimal outcomes' (LOS ≤5 days, discharge without complications, and no readmission within 30 days). RESULTS: Among 982 patients with adhesive SBO, successful NOM occurred in 561 (57.1%), 224 (22.8%) underwent NOM-T, and 197 (20.1%) proceeded DTS. The mean(s.d.) LOS was 5.3(9.0), 12.9(11.4), and 7.7(8.0) days respectively (P < 0.001). Optimal outcomes were achieved in 61.0%, 16.1%, and 37.6% respectively (P < 0.001) and full guideline compliance was observed in 17.2%, 10.1%, and 0.4% respectively. CONCLUSION: Patients with adhesive SBO whose care was aligned with the Bologna guidelines had a shorter LOS and a greater incidence of optimal outcomes. Addressing evidence-to-practice gaps through implementation strategies that consider contextual factors will enhance guideline adoption and patient outcomes.
Sujets associés
Intestinal and Peritoneal AdhesionsAppendicitis Diagnosis and ManagementAbdominal Surgery and Complications