TY - JOUR
T1 - Minimally Invasive Surgery in Acute Bowel Obstruction
T2 - Should It Become the Standard of Care? A Prospective, Single Center, Observational Study
AU - Hoi, Hannes
AU - Gruenbart, Martin
AU - de Cillia, Michael
AU - Uzel, Robert
AU - Hofer, Hannah
AU - Schlosser, Lisa
AU - Tschann, Peter
AU - Weiss, Helmut
AU - Mittermair, Christof
N1 - Lehr-KH John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria
PY - 2024/12
Y1 - 2024/12
N2 - Background/Objectives: This study was conducted to determine whether a structured clinical pathway can help to safely implement minimally invasive surgery (MIS) as the standard approach in surgery for acute bowel obstruction (ABO). Methods: A prospective analysis was performed on consecutive patients undergoing MIS for ABO at a single center in 2021 and 2022. Prior to the study onset, a structured treatment pathway was defined to apply MIS in all patients. The rate of success in the MIS and patient-, surgeon- and outcome-specific parameters with a focus on complication and conversion rates were analyzed. Results: Compared to a historical control group, the conversion rate from MIS to open surgery (OS) nearly doubled from 20.4% to 36.4% (p = 0.14). The complication rate in converted patients was 43.8% vs. 7.15% in non-converted patients (p < 0.05). Conclusions: A structured clinical pathway, including technical standardization and preoperative decisional processes, can be used to implement MIS as a primary surgical treatment in ABO. This is accompanied by high conversion rates and a significant increase in postoperative complications in patients undergoing conversion. Individual decision-making concerning the surgical approach remains paramount to prevent complications and high conversion rates.
AB - Background/Objectives: This study was conducted to determine whether a structured clinical pathway can help to safely implement minimally invasive surgery (MIS) as the standard approach in surgery for acute bowel obstruction (ABO). Methods: A prospective analysis was performed on consecutive patients undergoing MIS for ABO at a single center in 2021 and 2022. Prior to the study onset, a structured treatment pathway was defined to apply MIS in all patients. The rate of success in the MIS and patient-, surgeon- and outcome-specific parameters with a focus on complication and conversion rates were analyzed. Results: Compared to a historical control group, the conversion rate from MIS to open surgery (OS) nearly doubled from 20.4% to 36.4% (p = 0.14). The complication rate in converted patients was 43.8% vs. 7.15% in non-converted patients (p < 0.05). Conclusions: A structured clinical pathway, including technical standardization and preoperative decisional processes, can be used to implement MIS as a primary surgical treatment in ABO. This is accompanied by high conversion rates and a significant increase in postoperative complications in patients undergoing conversion. Individual decision-making concerning the surgical approach remains paramount to prevent complications and high conversion rates.
KW - Acute bowel obstruction
KW - Laparoscopy
KW - Minimally invasive surgery
KW - Open surgery
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001387989300001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.3390/jcm13247852
DO - 10.3390/jcm13247852
M3 - Original Article
C2 - 39768775
SN - 2077-0383
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 24
M1 - 7852
ER -