Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi Matsumoto, Nagano, 390-8621, Japan.
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi Matsumoto, Nagano, 390-8621, Japan.
Asian J Surg. 2021 Jan;44(1):292-297. doi: 10.1016/j.asjsur.2020.07.012. Epub 2020 Jul 28.
/Objective: The feces sign has been reported as a possible predictive factor for non-operative treatment of small bowel obstruction. However, its relationship with prognosis of non-emergency adhesive small bowel obstruction remains unclear. This study aimed to clarify the relationship between the feces sign and prognosis of non-emergency adhesive small bowel obstruction.
Ninety-two patients with non-emergency adhesive small bowel obstruction with the transitional zone visible on computed tomography were included. Patients were categorized into two groups: feces sign positive (n = 40) and negative (n = 52). Clinical features and prognosis were compared between the two groups. Cox proportional hazards regression models incorporating the feces sign were used to analyze odds of diet resumption and discharge.
Patients with feces sign were younger (p = 0.015), had a higher body mass index (p = 0.027), and a lower white blood cell count (p = 0.019) on admission. More patients with feces sign were successfully treated with fasting and/or nasogastric tube placement (p < 0.001), and no patient with feces sign suffered from recurrent obstruction after diet resumption. Kaplan-Meier analysis showed that patients with feces sign took less time for diet resumption (p = 0.007) and discharge (p = 0.004) than those without it. Using Cox proportional hazards regression model, the feces sign was reported as an independent predictor of diet resumption (odds ratio 1.685, p = 0.018) and discharge (odds ratio 1.861, p = 0.007).
The feces sign is associated with improved odds for diet resumption and discharge.
/目的：粪便征已被报道为非手术治疗小肠梗阻的可能预测因素。然而，其与非紧急粘连性小肠梗阻的预后的关系尚不清楚。本研究旨在阐明粪便征与非紧急粘连性小肠梗阻的预后之间的关系。
共纳入 92 例 CT 可见过渡带的非紧急粘连性小肠梗阻患者。患者分为粪便征阳性组（n=40）和阴性组（n=52）。比较两组的临床特征和预后。采用包含粪便征的Cox 比例风险回归模型分析恢复饮食和出院的可能性。
粪便征组患者年龄较小（p=0.015），入院时体重指数较高（p=0.027），白细胞计数较低（p=0.019）。更多的粪便征患者经禁食和/或鼻胃管放置成功治疗（p<0.001），且无粪便征患者在恢复饮食后发生复发性梗阻。Kaplan-Meier 分析显示，粪便征组患者恢复饮食（p=0.007）和出院（p=0.004）的时间均短于无粪便征组患者。采用 Cox 比例风险回归模型，粪便征被报道为恢复饮食（优势比 1.685，p=0.018）和出院（优势比 1.861，p=0.007）的独立预测因素。
粪便征与恢复饮食和出院的几率增加相关。
