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Introduction <p>Despite its clinical significance and the fact that mechanical adhesive small bowel obstruction (SBO) is a common surgical emergency, data on the prevalence, types and risk factors of morbidity remain limited. This study aims to assess the frequency and kind of complications and identify patient- and surgery-related risk factors, with particular attention to the impact of surgical timing.</p> Methods <p>We conducted a retrospective analysis of patients who underwent surgery for mechanical adhesive SBO at the University Hospital Erlangen over a five-year period (2018–2022). Postoperative complications and their outcomes were assessed. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with postoperative morbidity.</p> Results <p>Postoperative in-hospital morbidity occurred in 22.2% of patients, the majority of which were surgery-related (71.2%). The most frequent complications were postoperative paralytic ileus (6.0%), wound healing disorders (5.1%) and cardiopulmonary complications (5.1%). The in-hospital mortality rate was 2.1%. Postoperative morbidity was managed conservatively in 75.0% of cases and required reoperation in 25.0%. In 89.4% of affected patients, morbidity was associated with prolonged hospitalization. Multivariate analysis identified BMI &gt; 25 kg/m² (OR 2.9; 95% CI, 1.4–6.0; p = 0.007), ASA class III–IV (OR 3.0; 95% CI, 1.4–6.5; p = 0.007) and surgery duration &gt; 110 minutes (OR 4.0; 95% CI, 1.9–8.7; p &lt; 0.001) as independent predictors of morbidity. In contrast, surgical timing – specifically nighttime procedures (p = 0.200) and weekend surgery (p = 0.572) - was not significantly associated with increased risk.</p> Conclusion <p>In surgically treated patients with adhesive small bowel obstruction, postoperative morbidity was independently associated with elevated BMI, ASA class III–IV, and prolonged operative duration. In contrast, nighttime and weekend surgery were not significantly associated with postoperative morbidity in this cohort. These findings underscore the importance of risk-adapted perioperative optimization and close interdisciplinary management, particularly in high-risk patients.</p>

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Postoperative morbidity following surgery for mechanical adhesive small bowel obstruction: prevalence, risk factors and clinical outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月25日

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  • Timur Buniatov,
  • Matthias Maak,
  • Axel Denz,
  • Christian Krautz,
  • Georg F. Weber,
  • Robert Grützmann,
  • Anke Mittelstädt,
  • Maximilian Brunner

摘要

Introduction

Despite its clinical significance and the fact that mechanical adhesive small bowel obstruction (SBO) is a common surgical emergency, data on the prevalence, types and risk factors of morbidity remain limited. This study aims to assess the frequency and kind of complications and identify patient- and surgery-related risk factors, with particular attention to the impact of surgical timing.

Methods

We conducted a retrospective analysis of patients who underwent surgery for mechanical adhesive SBO at the University Hospital Erlangen over a five-year period (2018–2022). Postoperative complications and their outcomes were assessed. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors associated with postoperative morbidity.

Results

Postoperative in-hospital morbidity occurred in 22.2% of patients, the majority of which were surgery-related (71.2%). The most frequent complications were postoperative paralytic ileus (6.0%), wound healing disorders (5.1%) and cardiopulmonary complications (5.1%). The in-hospital mortality rate was 2.1%. Postoperative morbidity was managed conservatively in 75.0% of cases and required reoperation in 25.0%. In 89.4% of affected patients, morbidity was associated with prolonged hospitalization. Multivariate analysis identified BMI > 25 kg/m² (OR 2.9; 95% CI, 1.4–6.0; p = 0.007), ASA class III–IV (OR 3.0; 95% CI, 1.4–6.5; p = 0.007) and surgery duration > 110 minutes (OR 4.0; 95% CI, 1.9–8.7; p < 0.001) as independent predictors of morbidity. In contrast, surgical timing – specifically nighttime procedures (p = 0.200) and weekend surgery (p = 0.572) - was not significantly associated with increased risk.

Conclusion

In surgically treated patients with adhesive small bowel obstruction, postoperative morbidity was independently associated with elevated BMI, ASA class III–IV, and prolonged operative duration. In contrast, nighttime and weekend surgery were not significantly associated with postoperative morbidity in this cohort. These findings underscore the importance of risk-adapted perioperative optimization and close interdisciplinary management, particularly in high-risk patients.