Abstract
Adhesive small bowel obstruction (ASBO) is one of the major causes of postoperative morbidity. Non-surgical management is generally applied to non-strangulated ASBO. Several factors have been reported to affect the response to non-surgical management in patients with ASBO. However, the association between sex differences and non-strangulated ASBO remains unclear. This study aimed to elucidate the effect of sex differences in non-strangulated postoperative ASBO. We divided 139 patients with a first episode of non-strangulated postoperative ASBO into two groups: male group (n=83) and female group (n=56). Clinical features and prognosis were compared between the two groups. Female patients had lower proportions of oesophageal/gastric malignancies (P=0.044) and colorectal malignancies (P=0.030) and a higher proportion of uterine/ovarian malignancies (P < 0.001) than male patients did. More female patients required surgical management than male patients (P=0.003) did. Hospital length of stay (LOS) was longer (P=0.046) in the female group than in the male group. Multiple logistic regression analysis showed that the female sex was associated with an increased risk of the need for surgical management (odds ratio 5.318, P=0.006). Cox proportional hazards regression analysis revealed that the female sex was positively associated with increased LOS (hazard ratio 0.687, P=0.045). Female sex was associated with failure of non-surgical management and increased LOS in patients with non-strangulated postoperative ASBO.
Highlights
Adhesive small bowel obstruction (ASBO) is one of the major causes of postoperative morbidity
Female sex adversely affected the response to conservative treatment and length of stay (LOS) in patients with non-strangulated postoperative ASBO
Based on computed tomography (CT) imaging findings, we have previously reported that the feces sign (FS) in the transitional zone (TZ) is a good prognostic marker in non-strangulated postoperative ASBO, whereas male sex shows a tendency to be associated with an increased odds for hospital discharge [5]
Summary
Adhesive small bowel obstruction (ASBO) is one of the major causes of postoperative morbidity. Conservative treatment is generally applied to non-strangulated ASBO. Several factors have been reported to affect the response to conservative treatment in patients with ASBO. The association between sex differences and non-strangulated ASBO remains unclear. This study aimed to elucidate the effect of sex differences in non-strangulated postoperative ASBO. Based on CT imaging findings, we have previously reported that the feces sign (FS) in the transitional zone (TZ) is a good prognostic marker in non-strangulated postoperative ASBO, whereas male sex shows a tendency to be associated with an increased odds for hospital discharge (odds ratio 1.682, 95% confidence interval [CI] 0.972–2.911, p = 0.063) [5]. We aimed to evaluate the effect of sex differences in non-strangulated postoperative ASBO
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