ArticleAmerican journal of translational research2025
Surgical risk factors in clinical use of transnasal intestinal decompression for acute complete adhesive non-strangulated small bowel obstruction.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the clinical value of transnasal intestinal decompression tube placement in the treatment of acute complete adhesive non-strangulated small bowel obstruction (ACANSBO) and to identify independent risk factors associated with the need for surgical intervention.
methodsA retrospective analysis was conducted on 98 patients with ACANSBO treated at Tianjin Union Medical Center from January 2018 to December 2024. All patients underwent transnasal intestinal decompression combined with contrast imaging. Based on whether surgical treatment was required, patients were categorized into a surgical group (n = 38) and a non-surgical group (n = 60). Baseline characteristics and treatment-related variables were compared between the groups. Univariate and multivariate logistic regression analyses were performed to identify factors influencing the need for surgery, and a predictive model was subsequently developed.
resultsSignificant differences were observed between the surgical and non-surgical groups in the following factors: pre-treatment Acute Physiology And Chronic Health Evaluation II (APACHE II) score, age, presence of ascites during treatment, leukocyte count, duration of non-surgical treatment, time to resolution of air-fluid levels, and time to return of anal exhaust (all P < 0.05). Multivariate analysis identified ascites, age, APACHE II score, time to resolution of air-fluid levels, and time to return of anal exhaust as independent predictors of surgical requirement. The predictive model based on these variables demonstrated excellent discriminatory performance, with an area under the receiver operating characteristic curve (AUC) of 0.987.
conclusionTransnasal intestinal decompression combined with contrast imaging is effective in the management of ACANSBO. Ascites, advanced age, higher APACHE II score, delayed resolution of air-fluid levels, and prolonged time to return of anal exhaust were independent risk factors for surgical intervention. These findings support individualized clinical decision-making to optimize outcome.
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