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World Journal of Emergency Surgery :... 2018Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are... (Review)
Review
Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group.
BACKGROUND
Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups.
METHODS
The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion.
RECOMMENDATIONS
Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention.
DISCUSSION
This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
Topics: Disease Management; General Surgery; Guidelines as Topic; Humans; Intestinal Obstruction; Tissue Adhesions; Treatment Outcome
PubMed: 29946347
DOI: 10.1186/s13017-018-0185-2 -
The Surgical Clinics of North America Dec 2021
Topics: Attitude; Consensus; Education, Medical; General Surgery; Humans; Interprofessional Relations; Occupational Stress
PubMed: 34774278
DOI: 10.1016/j.suc.2021.09.008 -
Current Problems in Surgery Apr 2016
Topics: Environmental Health; General Surgery; Humans; Medical Waste; Medical Waste Disposal; Operating Rooms; Program Development; United States
PubMed: 27102334
DOI: 10.1067/j.cpsurg.2016.03.001 -
Best Practice & Research. Clinical... Sep 2016Neurological injury is a major limitation of aortic surgery, whether it involves spinal cord injury following intervention to the thoracoabdominal aorta, or stroke... (Review)
Review
Neurological injury is a major limitation of aortic surgery, whether it involves spinal cord injury following intervention to the thoracoabdominal aorta, or stroke following surgery on the arch and ascending aorta. Despite an extensive body of literature and various proposals, a completely effective strategy to prevent or treat neurological injury remains elusive. In this article, we summarise the evidence for established and emerging strategies, and review current concepts in pathophysiology and risk assessment as they relate to neurological injury.
Topics: Aorta; General Surgery; Humans; Neuroprotection; Risk Factors; Spinal Cord Injuries
PubMed: 27650340
DOI: 10.1016/j.bpa.2016.05.002 -
Langenbeck's Archives of Surgery Mar 2003
Topics: General Surgery; Humans; Molecular Biology; Surgical Procedures, Operative
PubMed: 12769124
DOI: 10.1007/s00423-003-0365-7 -
American Journal of Surgery Jun 2021
Topics: Editorial Policies; General Surgery; Humans; Periodicals as Topic; Racism; United States
PubMed: 34024427
DOI: 10.1016/j.amjsurg.2021.04.021 -
Advances in Surgery Sep 2020
Review
Topics: Artificial Intelligence; Certification; Clinical Competence; Crowdsourcing; Formative Feedback; General Surgery; Humans; Internship and Residency; Intraoperative Complications; Intraoperative Period; Medical Errors; Mentoring; Peer Review; Quality Improvement; Surgeons; United States; Video Recording
PubMed: 32713431
DOI: 10.1016/j.yasu.2020.03.002 -
The Journal of Hospital Infection Jun 1991There is a need for wider adoption of safer surgical techniques to reduce the chances of human immunodeficiency virus (HIV) transmission in the operating theatre. When a... (Review)
Review
There is a need for wider adoption of safer surgical techniques to reduce the chances of human immunodeficiency virus (HIV) transmission in the operating theatre. When a patient is known to have HIV infection extra precautions, including the wearing of additional protective clothing, should be carried out, even though it is not known whether such special measures are of value.
Topics: Asepsis; General Surgery; Gloves, Surgical; HIV Infections; HIV-1; Humans; Occupational Diseases; Operating Rooms; Surgical Instruments; Surgical Procedures, Operative
PubMed: 1679782
DOI: 10.1016/0195-6701(91)90022-z -
Current Problems in Surgery Sep 2020
Review
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Disease Transmission, Infectious; General Surgery; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2; State Medicine; Surgical Procedures, Operative; United Kingdom
PubMed: 32948255
DOI: 10.1016/j.cpsurg.2020.100856 -
Annals of Plastic Surgery Mar 2013
Topics: Communication; General Surgery; Humans; Medical Errors; Occupational Diseases; Occupational Health; Operating Rooms; Safety Management
PubMed: 23407143
DOI: 10.1097/SAP.0b013e31828584bc