Department of Surgery, Sjælland University Hospital, Køge, Denmark.
Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Eur J Trauma Emerg Surg. 2023 Apr;49(2):1121-1130. doi: 10.1007/s00068-022-02171-y. Epub 2022 Nov 10.
The optimal management of small bowel obstruction (SBO) remains a matter of debate and treatment varies internationally. In Denmark, a more surgically aggressive strategy has traditionally been used, but to what extent patient outcomes differ from international reports is unknown. This study aimed to describe the current management and outcomes of patients admitted with SBO in Denmark.
This was a prospective cohort study conducted at six acute hospitals in Denmark over a 4-month period. Patients aged ≥ 18 years with a clinical or radiological diagnosis of SBO were eligible. Primary outcomes were 30 day morbidity and mortality rates.
316 patients were included during the study period. The median age was 72 years and 56% were female. Diagnosis was made by computed tomography (CT) in 313 patients (99.1%), with the remaining three diagnosed clinically. Non-operative management was the initial strategy in 152 patients (48.1%) and successful in 119 (78.3%). Urgent surgery was performed in the remaining 164 (51.9%), with a laparoscopic approach used in 84 patients (51.2%). The entire cohort had a 30 day mortality rate of 7.3% and a 30 day morbidity rate of 17.1%.
The management of SBO in Denmark differs markedly to previous international reports, with an almost ubiquitous use of CT for diagnosis and a high proportion of patients undergoing urgent surgery. Despite higher rates of surgery, patient outcomes are broadly similar to reports of more conservative strategies, perhaps due to a reduction in delayed operations.
Trial registration number: NCT04750811. Trial registration date: 11/02/2021.
小肠梗阻（SBO）的最佳治疗方法仍存在争议，且治疗方法在国际上存在差异。在丹麦，传统上采用更具侵袭性的手术策略，但患者的结局与国际报道有何不同尚不清楚。本研究旨在描述丹麦 SBO 患者的当前治疗方法和结局。
这是一项在丹麦六家急性医院进行的为期 4 个月的前瞻性队列研究。纳入年龄≥18 岁、有临床或影像学诊断为 SBO 的患者。主要结局为 30 天发病率和死亡率。
在研究期间纳入了 316 名患者。中位年龄为 72 岁，56%为女性。313 名患者（99.1%）通过计算机断层扫描（CT）诊断，其余 3 名通过临床诊断。152 名患者（48.1%）初始采用非手术治疗，其中 119 名（78.3%）成功。其余 164 名患者（51.9%）进行了紧急手术，其中 84 名（51.2%）采用腹腔镜手术。整个队列的 30 天死亡率为 7.3%，30 天发病率为 17.1%。
丹麦 SBO 的治疗方法与之前的国际报道明显不同，几乎普遍使用 CT 进行诊断，且有很高比例的患者接受紧急手术。尽管手术率较高，但患者结局与更保守策略的报道大致相似，这可能是由于减少了延误手术。
注册号：NCT04750811。试验注册日期：2021 年 2 月 11 日。
