Observational studySurgical endoscopy2025
Preoperative factors influence technique selection in surgical management of small bowel obstruction: findings from the SnapSBO multinational prospective observational study.
Observational study in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Dogma, data, and decision-making: a history of treatment for small-bowel obstruction.World journal of emergency surgery : WJES · 2026Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLaparoscopic surgery is a standard approach for many elective gastrointestinal procedures but remains underutilized for emergent small bowel obstruction (SBO) resolution. This study evaluates how preoperative factors influence the initial choice of laparoscopic versus open surgery for SBO, and how intra-operative events may modify the initial operative approach and impact outcomes.
methodsProspective, multicenter, multinational time-bound observational study of SBO patients. Preoperative data and operative details were collected. Primary outcome was initial surgical approach (laparoscopic or open). Secondary outcomes included conversion to open and post-operative complications. Uni- and multivariable analyses identified predictors of approach selection and conversion.
resultsOf 1737 patients, 876 (50.4%) underwent surgery with 172 (19.6%) initially explored using laparoscopy; 60 (34.8%) of those cases converted to open. Laparoscopy was initially pursued in younger patients (mean 60.9 ± 18.2 vs. 66.5 ± 17.5 years, p < 0.001), with fewer comorbidities (66.3% vs. 75.1%, p = 0.018), and less frequent prior abdominal surgery (43.6% vs. 29.8%, p < 0.001) or multiple previous operations (mean 1.5 ± 1 vs. 1.9 ± 1.3, p = 0.03). Presumed etiology influenced approach: laparoscopy was more frequently utilized for adhesive single-band obstructions (60.5% vs. 45.2%), whereas open surgery was more common for hernias (24.4% vs. 38.1%). Both abdominal malignancy (OR = 4.74, p = 0.015) and free intraperitoneal fluid on CT (OR = 6.79, p < 0.001) surfaced as independent predictors of conversion. Laparoscopy was associated with fewer complications (surgical: 13.9% vs. 23.1%, p = 0.009; medical: 9.8% vs. 20.7%, p = 0.001) and lower mortality (0.6% vs. 8.3%, p < 0.001) than open surgery.
conclusionsPreoperative patient factors and disease etiology are associated with initial operative technique selection, while intraoperative events and findings appear to adjust the probability of conversion to open. Preoperative assessment combined with flexibility in intraoperative decision-making appears to be associated with optimal outcomes in SBO management.
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Registered trials
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