Long-term follow-up and cost analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions.
BACKGROUND
This study examined the natural course of patients following surgery for small bowel obstruction (SBO) caused by abdominal adhesions. In addition, a cost analysis was performed.


METHODS
A retrospective analysis was undertaken of 102 patients who underwent surgery between 1987 and 1992 for intestinal obstruction due to abdominal adhesions.


RESULTS
Median follow-up was 14 years. The 102 patients experienced 273 episodes of intestinal obstruction after the index operation, of which 237 involved inpatient readmissions; 47.3 per cent of the episodes resulted in further surgery. Single band adhesions were more common in patients with no previous abdominal surgery (P < 0.001). Some 52.0 per cent of the patients had undergone only one operation for SBO. A mean of 2.7 episodes per patient occurred after the index operation. The cost of adhesion-related problems in this study was 1,588,594 euros or 6702 euros per inpatient episode.


CONCLUSIONS
The readmission rate in a selected cohort of patients with proven intra-abdominal adhesions was higher than reported previously. The annual cost of adhesion-related problems in Sweden was estimated as 39.9-59.5 million euros, and the cost of inpatient readmissions was almost equal to that for gastric cancer.
Tingstedt
B
B
Department of Surgery, Lund University, Lund, Sweden. bobby.tingstedt@med.lu.se
Isaksson
J
J
Andersson
R
R
D000005:Abdomen / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000191:economics / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics; D012008:Recurrence; D012189:Retrospective Studies; D013548:Sweden; D013997:Time Factors; D000267:Tissue Adhesions / Q000150:complications / Q000191:economics / Q000601:surgery; D016896:Treatment Outcome