IMPACT OF SURGICAL VS. NON-SURGICAL MANAGEMENT OF SMALL BOWEL OBSTRUCTION: A META-ANALYSIS
Main Article Content
Keywords
Small Bowel Obstruction, Surgical Management, Non-surgical Management, Mortality, Recurrence, Complications, Hospital Stay, Meta-Analysis.
Abstract
Small Bowel Obstruction, which is abbreviated as SBO, is a common pathology that presents with acute abdominal pain, nausea, vomiting and distension. It is a condition that happens when the small intestine is either partly or wholly obstructed and, hence, cannot effectively transport fluids, foods, and gases. It is thus a significant cause of gastrointestinal admissions, and the disease is more prevalent in the ageing population, especially those with a prior abdominal operation. In the absence of treatment, SBO evokes some hazardous conditions, inclusive of ischemia, perforation, and sepsis, and standard management practices should, therefore, be encouraged. This meta-analysis seeks to compare the surgical and non-surgical treatment of SBO on specific patient parameters like mortality, morbidity, hospital stay and recurrence and complications. The aim is to identify the treatment method that guarantees higher patient satisfaction. Databases used in the literature review include PubMed, Cochrane Library, Embase, and Scopus for all titles posted from 2003 to 2023 that compared surgical and non-surgical SBO management. Endpoints that were identified in the primary research were mortality, complications, days of hospital stay and rate of recurrences. Heterogeneity was established using the I² tests, and the studies were analyzed using both fixed and random effects. Non-surgical methods, while advantageous in simple cases, have high recurrences and readmission rates in hospitals. Intervention is recommended in complicated cases as it leads to the reduction of mortality and further SBO complications. At the same time, non-operative interventions have fewer complications but high rates of recurrence in uncomplicated SBO. Research should explore the best approaches to the management of CINV with emphasis placed on low-resource settings while also exploring models that would help in the management of patients. The obstructions must be managed based on patients’ characteristics, medical histories, and obstruction type.
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Hind saleh Alhammadi
University of Sharjah, College of Medicine, U21100461@sharjah.ac.ae, https://orcid.org/0009-0003-0037-8775
Sara Alaaeddin Bassam Haroun
University of Sharjah, College of Medicine, Harounsara7@gmail.com, https://orcid.org/my-orcid?orcid=0009-0001-0528-3404
Ihsan Farooq Akbar
Shifa international hospital, Email id: ihsanfarooqakbar@gmail.com, Orcid id : https://orcid.org/0009-0002-4768-0966
Muhammad Salman Arif
Shifa international hospital, salmanbharwana@gmail.com https://orcid.org/0009-0007-7763-9514
sabiha ahmad
Uni/hospital - Zhejiang university Email -sabiha.ahmad321@gmail.com, Orchid id-0009-0002-6132-4618
Mona Abdelatif Mahgoub
Hospital: Saudi German Hospital, Email: mahgoub.mona@hotmail.com
ORCID: https://orcid.org/0009-0009-4084-4594
Ahmed Alfatih Sirelkhatim Fadul
University: Yangzhou university, Email: Ahmed.9339@hotmail.com, ORCID ID: 0000-0002-9676-806X
Mahra Salem Mubarak Albreiki
University of Sharjah, College of Medicine, M.04.albreiki@gmail.com, https://orcid.org/0009-0006-3449-3474
Dr. Keziah Nithiya Suresh
Thumbay University Hospital, keziahsureshdxb@gmail.com, ORCID iD: 0009-0000-5206-2295
Maryam Hafazalla Mohamed
Uni/hospital: Saudi German hospital Email: Mariam.h_99@live.com, Orchid id: https://orcid.org/0009-0004-3088-4916