EN
TÜRKÇE
Withdrawn - 20
Identifying Risk Factors for Surgical Intervention in Pediatric Adhesive Small Bowel Obstruction: Insights and Outcomes
B Aziza, Y Houas, N Ben Alaya, A Dridi, F Thamri, A Guitouni, Y Kerkeni, S Sahli, R Jouini
children hospital Bechir Hamza, Pediatric surgery department A Tunis Tunisia
Introduction
Adhesive small bowel obstruction (ASBO) is one of the most important cause of postoperative morbidity in children who underwent abdominal surgery. Identifying predictors for surgery can enhance clinical decision-making and patient outcomes
Aim of the study
To identify risk factors associated with the need for surgical intervention in children with ASBO.
Materials and methods
A retrospective cohort study was conducted, involving children diagnosed with ASBO over a five-year period. The patients were divided according to operative management (OPM; n=34) or non-operative management (NOPM; n=78). potential risk factors influencing the need for surgery were identified using univariate and multivariate statistical analyses.
Results
Of the 112 children ASBO, 34 (30.4%) required surgical intervention. There were no significant differences between the surgical and conservative management groups in terms of age and gender (p=0.77, 0.21). However, patients in the operative management group had a higher frequency of emergency initial surgeries (p=0.037) and were more likely to have had a midline incision (p=0.016). The duration of symptoms was longer in the surgical group (4.3 days compared to 2.8 days; p<0.001). Factors strongly associated with the need for surgery included significant abdominal distension (OR 2.9, 95% CI 1.6-5.1), elevated C-reactive protein (OR 2.6, 95% CI 1.4-4.7). Other factors linked to surgery were peritonitis at the initial operation (p=0.008), bowel resection (p=0.001), and infectious complications (p=0.039). The median follow-up period was 2.6 years (1 month - 5 years). Rehospitalization for a new episode of ASBO occurred in 26.4% of surgically treated patients and 54% of conservatively managed patients (p=0.028; OR 1.72, 95% CI 1.00-2.95)
Conclusion
Early identification of these predictive factors can assist clinicians in making informed decisions regarding the management of ASBO potentially leading to more effective treatments and better outcomes.