[Analysis of the outcome of the treatment of small bowel obstruction and factors which determine the outcome (10-year experience at the Kaunas Medical University Clinic)].
OBJECTIVE
To evaluate the results of the treatment of small bowel obstruction in the Surgical clinic of Kaunas University of Medicine in 1990-1999, the changes of the results of the treatment, to evaluate the factors, which determine these changes.


METHODS
489 patients with small bowel obstruction (SBO) were treated during 10-year period. Acute SBO was found in 433 (88.5%) cases; 322 (65.8%) patients underwent surgery. The patients were divided into two groups: 1990-1995 year group (A) and 1996-1999 year group (B) according to the newly implemented methods of diagnostics and treatment (computer-aided diagnosis, laparoscopic cutting of adhesions, conservative small bowel decompression with long intestinal tube and etc.). Both groups were statistically similar. By means of statistical methods factors, which determine the results of the treatment of SBO, were found and the differences of distribution of these factors in both groups were evaluated.


RESULTS
The mortality rate was 10.3% in group A and 1.8%--in group B. The most significant factors, which determine the outcome of the treatment of SBO, were: the time period of making diagnosis, adjacent illnesses, small bowel necrosis and its length, acute SBO, SBO due to multiple adhesions, surgical methods. In comparing both groups, they differed according to the time of making diagnosis (18.6 h and 9.6 h), the frequency of small bowel necrosis (14.2% and 5.7% cases); the methods of surgery also differed.


CONCLUSIONS
The results of the treatment of SBO improved. The short-cut of the time period to make diagnosis, the more rare cases of bowel necrosis and new surgical methods influenced these changes.
Bogusevicius
Algirdas
A
Kauno medicinos universiteto Chirurgijos klinika, Eiveniu 2, 3007 Kaunas.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome