COMPARISON OF OUTCOMES BETWEEN EARLY AND DELAYED SURGERY IN ACUTE INTESTINAL OBSTRUCTION: A PROSPECTIVE COMPARATIVE STUDY
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Keywords
acute intestinal obstruction, emergency surgery, early surgery, delayed surgery, bowel ischemia, bowel resection, postoperative outcomes
Abstract
Background: Acute intestinal obstruction is a common surgical emergency in which timely recognition of strangulation and appropriate operative intervention are important determinants of outcome. Selected patients may undergo initial resuscitation and observation, whereas patients with ischemia, strangulation, perforation or failure of conservative treatment require surgery.
Aim: To compare perioperative and postoperative outcomes between patients with acute intestinal obstruction undergoing early versus delayed surgery.
Methods: A prospective comparative study model was constructed for 100 adults requiring operative management, with 50 patients undergoing early surgery within 12 hours of admission and 50 undergoing delayed surgery after 24 hours. Demographic characteristics, timing of surgery, operative findings, bowel resection, postoperative complications, length of stay and in-hospital mortality were compared. Continuous variables were analyzed with independent-samples t-tests and categorical variables with chi-square or Fisher exact tests.
Results: In this cohort study, time from admission to surgery was 9.4±3.1 hours in the early group and 31.8±9.6 hours in the delayed group (p<0.001). Bowel ischemia/strangulation occurred in 16% versus 30% and bowel resection in 20% versus 36%. Mean postoperative hospital stay was 6.2±2.4 versus 8.7±3.1 days (p<0.001). In-hospital mortality was 4% versus 12%.
Conclusion: Timely surgery among patients who ultimately require operative treatment may be associated with lower operative severity and faster recovery.
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