The burden of adhesive bowel obstruction requiring surgery in children: a single-center retrospective review.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-27 DOI:10.1007/s00383-024-05914-7

Jonathan Hencke, Gabriel Nonnenmacher, Steffan Loff

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引用次数: 0

Abstract

Purpose: Investigate causes, predictors, and complications of adhesive bowel obstruction (ABO) necessitating surgery in children.

Methods: Single-center retrospective review of operative cases classified as 'adhesive bowel obstruction ' between May 2014 and December 2023. Parameters assessed included previous surgeries, operative time (indicative of adhesion extent), length of stay and postoperative complications. Results were statistically analyzed afterward.

Results: We identified 71 patients with ABO; seven had recurrences. Age (11 d-18 y, median 5.9 y) and time after surgery (four days-16 years, median 6.4 months) varied considerably. Preceding appendicitis (16 cases), NEC (seven cases) and gastroschisis (five cases) were most prevalent. Operative time ranged from 43 min to 8.4 h, was longer after previous surgery during infancy (median 177 vs. 124 min), recurrent ABO (median 213 vs. 150 min) and significantly shorter after appendicitis (82 vs. 175 min). ICU stay (median 2 days) and hospital stay (median 11 days) reduced with age. 32 patients (41%) suffered complications, doubling mean lengths of stay. Bowel resection and longer surgery were associated with complications, while age and enterostomy creation were not.

Conclusion: ABO is an impactful complication with limited predictors. The high incidence of complications adds to the burden for patients, parents, and health systems.

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需要进行手术的儿童粘连性肠梗阻的负担：单中心回顾性研究。

目的：调查需要手术治疗的儿童粘连性肠梗阻（ABO）的原因、预测因素和并发症：单中心回顾性分析 2014 年 5 月至 2023 年 12 月间被归类为 "粘连性肠梗阻 "的手术病例。评估参数包括既往手术、手术时间（表明粘连程度）、住院时间和术后并发症。之后对结果进行了统计分析：我们共发现 71 例 ABO 患者，其中 7 例复发。年龄（11 天-18 岁，中位数 5.9 岁）和术后时间（4 天-16 年，中位数 6.4 个月）差异很大。先兆阑尾炎（16 例）、NEC（7 例）和胃裂（5 例）最为常见。手术时间从 43 分钟到 8.4 小时不等，婴儿期手术（中位数 177 分钟对 124 分钟）和复发性 ABO 手术（中位数 213 分钟对 150 分钟）的手术时间较长，而阑尾炎手术（82 分钟对 175 分钟）的手术时间明显较短。重症监护室停留时间（中位数为 2 天）和住院时间（中位数为 11 天）随着年龄的增长而缩短。32名患者（41%）出现并发症，平均住院时间延长一倍。肠切除术和手术时间延长与并发症有关，而年龄和肠造口术则无关：结论：ABO是一种影响巨大的并发症，但预测因素有限。并发症的高发生率加重了患者、家长和医疗系统的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor