Minimally Invasive Surgery in Acute Bowel Obstruction: Should It Become the Standard of Care? A Prospective, Single Center, Observational Study

Hannes Hoi, Martin Gruenbart, Michael de Cillia, Robert Uzel, Hannah Hofer, Lisa Schlosser, Peter Tschann, Helmut Weiss, Christof Mittermair

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

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.
Original languageEnglish
Article number7852
Number of pages11
JournalJournal of Clinical Medicine
Volume13
Issue number24
DOIs
Publication statusPublished - Dec 2024

Keywords

  • Acute bowel obstruction
  • Laparoscopy
  • Minimally invasive surgery
  • Open surgery

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