This study aims to describe the mechanisms of adhesive small bowel obstruction (SBO) and its morbidity, mortality and recurrence after surgery for SBO in a defined population. Retrospective study of 402 patients (240 women, median age 70 years, range 18–97) who underwent surgery for SBO in the Uppsala and Gävleborg regions in 2007–2012. Patients were followed to last note in medical records or death. The cause of obstruction was a fibrous band in 56% and diffuse adhesions in 44%. Early overall postoperative morbidity was 48 and 10% required a re-operation. Complications, intensive care and early mortality (n = 21, 5.2%) were related to age (p < 0.05) and American Society of Anesthesiologist’s class (p < 0.01). At a median follow-up of 66 months (0–122), 72 patients (18%) had been re-admitted because of SBO; 26 of them underwent a re-operation. Previous laparotomies (p = 0.013), diffuse adhesions (p = 0.050), and difficult surgery (bowel injury, operation time and bleeding, p = 0.034–0.003) related to recurrent SBO. The cohort spent 6735 days in hospital due to SBO; 772 of these days were due to recurrent SBO. In all, 61% of the cohort was alive at last follow-up. Late mortality was related to malignancies, cardiovascular disease, and other chronic diseases. About half of patients with SBO are elderly with co-morbidities which predispose to postoperative complications and mortality. Diffuse adhesions, which make surgery difficult, were common and related to future SBO. Overall, nearly one-fifth of patients needed re-admission for recurrent SBO. Continued research for preventing SBO is desirable. The study was registered at ClinicalTrials.gov (NCT03534596, retrospectively registered, 2018-05-24).

中文翻译：

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粘连性小肠梗阻的机制和手术结果；基于人口的研究。

这项研究的目的是描述在特定人群中粘连性小肠梗阻（SBO）的机制及其发病率，死亡率和术后SBO复发。回顾性研究2007年至2012年在Uppsala和Gävleborg地区进行SBO手术的402例患者（240名女性，中位年龄70岁，年龄在18-97之间）。追踪患者的病历或死亡记录。阻塞的原因是56％的纤维带和44％的弥漫性粘连。早期总体术后发病率为48％，需要再次手术的占10％。并发症，重症监护和早期死亡率（n = 21，5.2％）与年龄（p <0.05）和美国麻醉医师学会级别（p <0.01）有关。在66个月的中位随访期（0-122）中，有72例（18％）患者因SBO而再次入院。其中的26例进行了重新手术。先前与开腹手术相关的开腹手术（p = 0.013），弥漫性粘连（p = 0.050）和手术困难（大肠损伤，手术时间和出血，p = 0.034–0.003）。该人群因SBO而住院治疗了6735天；这些天中的772次归因于SBO复发。在最后一次随访中，总共有61％的人还活着。晚期死亡率与恶性肿瘤，心血管疾病和其他慢性疾病有关。SBO患者中约有一半是老年人，合并症易导致术后并发症和死亡。弥漫性粘连使手术困难，这很普遍，并且与将来的SBO有关。总体而言，近五分之一的患者需要再次入院以复发SBO。防止SBO的持续研究是可取的。该研究已在ClinicalTrials中注册。