Predictors for success of non-operative management of adhesive small bowel obstruction

BACKGROUND Majority of adhesive small bowel obstruction(SBO)cases can be managed nonoperatively.However,a proportion of patients failed non-operative management.AIM To evaluate the predictors of successful non-operative management in adhesive SBO.METHODS A retrospective study was performed for all consecutive cases of adhesive SBO from November 2015 to May 2018.Data collated included basic demographics,clinical presentation,biochemistry and imaging results and management outcomes.The imaging studies were independently analyzed by a radiologist who was blinded to the clinical outcomes.The patients were divided into group A operative(including those that failed initial non-operative management)and group B non-operative for analysis.RESULTS Of 252 patients were included in the final analysis;group A(n=90)(35.7%)and group B(n=162)(64.3%).There were no differences in the clinical features between both groups.Laboratory tests of inflammatory markers and lactate levels were similar in both groups.From the imaging findings,the presence of a definitive transition point[odds ratio(OR)=2.67,95%confidence interval(CI):0.98-7.32,P=0.048],presence of free fluid(OR=2.11,95%CI:1.15-3.89,P=0.015)and absence of small bowel faecal signs(OR=1.70,95%CI:1.01-2.88,P=0.047)were predictive of the need of surgical intervention.In patients that received water soluble contrast medium,the evidence of contrast in colon was 3.83 times predictive of successful non-operative management(95%CI:1.79-8.21,P=0.001).CONCLUSION The computed tomography findings can assist clinicians in deciding early surgical intervention in adhesive SBO cases that are unlikely to be successful with non-operative management to prevent associated morbidity and mortality.

Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention

Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast followthrough and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.

A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction

AIM:To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.METHODS:A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study.The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube(NGT) was used in 90 patients.The therapeutic efficacy was compared between the two groups.RESULTS:Compared with the NGT group,the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph(4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests(P < 0.01).The overall effectiveness rate was up to 89.6% in the ileus tube group and 46.7% in the NGT group(P < 0.01).And 10.4% of the patients in the ileus tube group and 53.3% of the NGT group underwent surgery.For recurrent adhesive bowel obstruction,ileus tube was also significantly more effective than NGT(95.8% vs 31.6%).In the ileus tube group,the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure(P < 0.05).The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery.CONCLUSION:Ileus tube can be used for adhesive small bowel obstruction.Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks.

Challenges in diagnosing adhesive small bowel obstruction

Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically.

Daikenchuto for postoperative adhesive small bowel obstruction:A systematic review and meta-analysis

AIMTo assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction （ASBO）.METHODSA systematic search of PubMed （MEDLINE）, CINAHL, the Cochrane Library and Ichushi Web was conducted, and the reference lists of review articles were hand-searched. The outcomes of interest were the incidence rate of surgery, the length of hospital days and mortality. The quality of the included studies, publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials （RCTs） and three retrospective cohort studies were selected for analysis. In the three RCTs, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.13; 95%CI： 0.03-0.50）. Similarly, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.53; 95%CI： 0.32-0.87） in the three cohort studies. The length of hospital stay and mortality were not measured or described consistently.CONCLUSIONThe present meta-analysis demonstrates that admini-stering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population. In order to better generalize these results, additional studies will be needed.

Risk Factors for the Development of Adhesive Small Bowel Obstruction after Abdominal and Pelvic Operations

Introduction: Adhesive small bowel obstruction (SBO) is a disease process that has been difficult to prevent. Mechanical barriers and chemical agents exist to disrupt the formation of adhesions following surgery but each associated with medical risk and financial burden. Identifying risk factors for developing SBO in patients post laparotomy would aid in the appropriate use of such agents. We hypothesize that there might be additional risk factors that are associated with a higher likelihood of SBO. Methods: A retrospective analysis from 2008 to 2012 was performed. Cases of SBO following previous laparotomy were compared to those without SBO. Results: 468 medical records were reviewed (57% male). Operations that caused the highest risks for SBO included gynecological, colorectal and hernia operations with prosthetic materials. 66% percent of patients underwent a prior abdominal or pelvic high-risk procedure. The average time from surgery to the development of SBO was 24 months (median 19 months). Patients who developed SBO had a median age of 58.4 years on initial surgery, average previous operative time of 4.3 hours, and an av-erage of two prior operations. For every hour of operative time, the odds of developing SBO increased by 33% (p 3 decreased the odds of SBO (p = 0.05). Conclusions: Longer operative times are associated with post-operative adhesive small bowel obstruction. Patients with an ASA score greater than or equal to 3 appear to have a reduced risk of adhesive small bowel obstruction.

Etiology and Management of Small Bowel Obstruction with Special Reference to Role of Laparoscopy—A Single Centre Experience

Background: Small bowel obstruction (SBO) is the commonly diagnosed disease in the emergency department. The diagnosis and management of small bowel obstruction varies among institutions. The role of laparoscopy in the management of small bowel obstruction is debatable. Aim: To study the profile, clinical features and management options of patients of small bowel obstruction with special emphasis on role of laparoscopy. Material and Methods: 51 consecutive patients with documented small bowel obstruction admitted in our department were studied from June 2016 to December 2018. All the patients above 12 years of age with small bowel obstruction were included. The diagnosis of small bowel obstruction (SBO) was made in these cases by detailed history, clinical examination and investigations. All these patients were received and adequately resuscitated. Non-operative (conservative) treatment was confirmed to those who met the standard parameters for such treatment and early surgical treatment was carried out whenever indicated. The operative procedure done was laparoscopy or open depending on the clinical features and condition of patient. Results: In our study, 51 patients mean age was 44.7 years with 27 Males and 24 females. 28 (54.9%) patients of our study presented with continuous abdominal pain followed by colicky pain in 23 (45.1%) patients. 34 (66.7%) patients on admission gave history of effortless vomiting. Distension of abdomen was present in 30 (58.8%) patients and constipation was present in 40 (78.4%) of our studied patients. On CT scan interloop fluid was present in 23 (45.1%) patients while transition point was present in 31 (60.8%) patients. Adhesion obstruction was found to be most common cause of obstruction 27 (52.9%) patients, followed by malignancy in 8 (15.7). 25 (49.0%) patients were managed conservatively and 26 (51%) were operated. 11 (21.6%) patients underwent laparoscopic adhesiolysis and 15 (29.4%) underwent exploratory laparotomy. The average operative time, recovery of bowel moments, hospital stay, and post-operative complications were less in the laparoscopic group than open group with statically significant difference between the two. Conclusion: Post-operative adhesion obstruction is the most common cause of small bowel obstruction. Laparoscopy is a safe and effective tool for the management of acute intestinal obstruction provided it is performed in selected patients by skilled surgeon.

Decreasing recurrent bowel obstructions,improving quality of life with physiotherapy:Controlled study

AIM To compare(1) quality of life and(2) rate of recurrent small bowel obstructions(SBO) for patients treated with novel manual physiotherapy vs no treatment. METHODS One hundred and three subjects(age 19-89) with a history of recurrent adhesive SBO were treated with a manual physiotherapy called the Clear Passage Approach(CPA) which focused on decreasing adhesive crosslinking in abdominopelvic viscera. Pre-and post-therapy data measured recurring obstructions and quality of life, using a validated test sent 90 d after therapy. Results were compared to 136 untreated control subjects who underwent the same measurements for subjects who did not receive any therapy, which is the normal course for patients with recurring SBO. Comparison of the groups allowed us to assess changes when the physiotherapy was added as an adjunct treatment for patients with recurring SBO.RESULTS Despite histories of more prior hospitalizations, obstructions, surgeries, and years impacted by bowel issues, the 103 CPA-treated subjects reported a significantly lower rate of repeat SBO than 136 untreated controls(total obstructions P = 0.0003; partial obstructions P = 0.0076). Subjects treated with the therapy demonstrated significant improvements in five of six total domains in the validated Small Bowel Obstruction Questionnaire(SBO-Q). Domains of diet, pain, gastrointestinal symptoms, quality of life(QOL) and pain severity when compared to post CPA treatment were significantly improved(P < 0.0001). The medication domain was not changed in the CPA treated group(P = 0.176).CONCLUSION CPA physical therapy was effective for patients with adhesive SBO with significantly lower recurrence rate, improvement in reported symptoms and overall quality of life of subjects.

Successful management of adhesion related small bowel ischemia without intestinal resection: A case report and review of literature

BACKGROUND Intraabdominal adhesions develop spontaneously or after an inflammatory process or surgical procedure in the abdomen.They are the most common cause of small bowel obstruction(SBO).SBO occasionally leads to intestinal ischemia(In Is)which can be a life-threatening condition that requires management as soon as possible.We herein report a case of SBO with In Is presented in our institution and treated without intestinal resection.CASE SUMMARY A 34-year-old man presented at the emergency department after a 12-h-onset diffuse abdominal pain,bloating and nausea.He had a history of traumatic right hepatectomy 11 years ago as well as adhesiolysis and resection of a long part of small bowel 2 years ago.An abdominal computed tomography(CT)showed dilated loops that led to the diagnosis of SBO.Due to deteriorating lactic acidosis,the patient was operated.Torsion of the small bowel around an adhesion led to2.30 m of ischemic ileum.After the application of N/S 40°C for 20 min,the intestine showed signs of improvement and it was decided to avoid resection and instead temporary close the abdomen with vacuum-pack technique.At the second-look laparotomy 48 h later,the intestine appeared normal.The patient was discharged on the 8 th post-op day in excellent condition.CONCLUSION In case of SBO caused by adhesions,extreme caution is needed if In Is is present,as the clinical signs are mild and you should rely for diagnosis in CT findings and lactate levels.Conservative surgical approach could reverse the effects of In Is,if performed quickly,so that intestinal resection is avoided and should be used even when minimum signs of viability are present.

咀嚼口香糖联合经鼻型肠梗阻导管治疗粘连性小肠梗阻的效果

目的探讨咀嚼口香糖联合经鼻型肠梗阻导管(NGT)治疗粘连性小肠梗阻(ASBO)的效果。方法回顾性选取2019年7月至2021年12月赣州市人民医院消化内科收治的87例ASBO患者为研究对象,按照干预措施不同将其分为对照组(35例)与研究组(52例)。对照组采用NGT治疗,研究组采用咀嚼口香糖联合NGT治疗。比较两组患者临床疗效、排气时间、排便时间、腹痛缓解时间、住院时间、白细胞计数(WBC)复常时间、C反应蛋白(CRP)复常时间、外科手术率、咽喉不适评分及腹内压水平。结果研究组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05)。研究组患者排气时间、排便时间、腹痛缓解时间均短于对照组,咽喉不适评分、外科手术率均低于对照组,差异有统计学意义(P<0.05)。两组患者住院时间、WBC复常时间、CRP复常时间比较,差异无统计学意义(P>0.05)。治疗前,两组患者腹内压比较,差异无统计学意义(P>0.05);治疗3 d,两组患者腹内压均低于本组治疗前,且研究组患者腹内压低于对照组,差异有统计学意义(P<0.05)。结论咀嚼口香糖联合NGT治疗ASBO疗效优于单纯NGT治疗,可改善NGT治疗的咽喉不适。

腹腔镜肠粘连松解术与开腹手术治疗粘连性肠梗阻的Meta分析

目的系统评价腹腔镜肠粘连松解术与开腹手术治疗粘连性肠梗阻的有效性及安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、ICTRP、CNKI、VIP、CBM和Wanfang Data数据库,收集腹腔镜肠粘连松解术与开腹手术治疗粘连性肠梗阻的随机对照试验(RCT),检索时限均为从建库至2017年3月。由2位评价者按照纳入与排除标准独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入31个研究,3293例患者,Meta分析结果显示,与开腹手术比较,腹腔镜肠粘连松解术能降低肠梗阻复发率(OR=0.18,95%CI 0.12~0.25,P<0.000 01)、总并发症发生率(OR=0.17,95%CI 0.13~0.23,P<0.000 01)、切口感染发生率(OR=0.21,95%CI 0.13~0.35,P<0.000 01)、肺部感染发生率(OR=0.35,95%CI 0.15~0.82,P=0.02)和术后肠漏发生率(OR=0.32,95%CI 0.15~0.70,P=0.005)。结论现有证据表明腹腔镜肠粘连松解术治疗粘连性肠梗阻的复发率和并发症发生率低。

改良肠梗阻导管技术在难治性粘连性肠梗阻的临床应用

目的评价改良肠梗阻导管技术在难治性粘连性肠梗阻的临床应用。方法 2012年2月至2017年6月对54例难治性粘连性肠梗阻患者采用改良肠梗阻导管技术治疗并进行随访。改良肠梗阻导管技术是采用球囊接力的方式通过肠梗阻的阻塞段和采用反复回拉肠梗阻导管的方式疏通粘连的肠道。术后第1,3,6个月及之后每半年进行随访并收集相关的临床和影像数据。结果 54例患者肠梗阻导管均成功放置,放置深度为越过屈氏韧带20 cm以上。54例中47例肠梗阻导管成功通过阻塞段进入结肠内,梗阻段通过率为87.0%。拔管后50例患者的肠梗阻症状及体征完全消失,4例患者由于小肠重度梗阻,导管无法缓解肠梗阻症状,遂行外科肠粘连松解术。影像随访3～38个月,造影复查显示48例对比剂进过小肠通畅,未见明显肠梗阻现象。临床随访6～45个月,2例肿瘤术后患者再发现肠梗阻表现。54例中6例患者在术后8～15个月死于肿瘤复发所致的全身衰竭;48例患者的肠梗阻症状和体征完全消失,无肠梗阻症状复发。结论改良肠梗阻导管技术是一种简单和有效的治疗难治性粘连性肠梗阻的方法。

急性黏连性小肠梗阻保守治疗无效的危险因素

目的探讨急性黏连性小肠梗阻保守治疗无效的危险因素。方法回顾性分析2016年3月至2020年3月北京大学第一医院急诊科收治初始保守治疗的340例急性黏连性小肠梗阻的临床资料,按照治疗效果分为保守治疗有效组(304例)和无效组(36例)。比较两组患者的基本资料、既往梗阻发作次数、有无发热、外周血白细胞计数、C-反应蛋白、CT显示梗阻部位、扩张肠管最大外径、有无腹腔积液和保守治疗时间的差异。根据单因素分析结果,应用Logistic多因素回归分析保守治疗无效的危险因素。结果在单因素分析中,保守治疗无效组的发热患者百分率(χ^(2)=35.734,P <0.01)、扩张肠管最大外径(Z=-3.435,P <0.01)、保守治疗时间(Z=-4.404,P <0.01)均大于保守治疗有效组,差异有统计学意义(P <0.05)。多因素回归分析显示,发热、扩张肠管最大外径及保守治疗时间是保守治疗无效的独立危险因素。扩张肠管最大外径、保守治疗时间的受试者工作特征(ROC)曲线下面积(AUC)分别是0.674、0.722,与保守治疗无效组相比,差异有统计学意义(P值分别是0.001、0.000),诊断截断点分别为3.55 cm和6.5 d。结论发热、扩张肠管最大外径> 3.55 cm、保守治疗时间> 6.5 d是急性黏连性小肠梗阻保守治疗无效的危险因素;加强病情评估,及早采取手术治疗可能使存在危险因素的患者获益。

绞窄性肠梗阻患者血浆D-dimer的变化及临床意义

目的:探讨血浆D-dimer在粘连性肠梗阻发生肠绞窄时的水平变化及对肠绞窄诊断的临床意义。方法:分析61例粘连性肠梗阻患者术前D-dimer水平,并比较单纯性肠梗阻、绞窄性肠梗阻患者血浆D-dimer水平及阳性率(D-dimer>0.3mg/L为阳性)。结果:肠绞窄患者血浆D-dimer水平及阳性率都较单纯粘连性肠梗阻患者明显增高(P<0.05)。结论:粘连性肠梗阻患者血浆D-dimer>0.3mg/L时,可提示肠绞窄的发生。

液体石蜡对粘连性小肠梗阻的干预作用

目的 观察液体石蜡在粘连性小肠梗阻病程中的干预作用.方法 选择湖州中心医院胃肠外科2014年12月至2016年6月收治的粘连性肠梗阻患者288例,按机械抽样法分为液体石蜡组和对照组,每组144例.对照组采用传统综合非手术治疗,胃肠减压2 h后,液体石蜡组经胃管注入液体石蜡3 mL/kg,夹闭胃管2 h.观察两组治疗后第1次排气时间、第1次排便时间、腹痛缓解时间、气液平消失时间、住院时间、手术率和不良反应发生情况.结果 治疗后液体石蜡组第1次排气时间、第1次排便时间、腹痛缓解时间、气液平消失时间、住院时间均较对照组明显缩短〔第1次排气时间（h）：29.97±19.71比49.28±33.61,第1次排便时间（h）：60.25±28.37比74.23±50.12,腹痛缓解时间（h）：35.78±20.98比51.83±25.02,气液平消失时间（h）：71.60±39.50比90.98±57.91,住院时间（d）：7.00±3.77比9.00±5.81,均P〈0.05〕,手术率较对照组明显降低〔18.75%（27/144）比27.08%（39/144）,P〈0.05〕.两组均无死亡病例.随访近1年液体石蜡组未见与研究相关的不良反应.结论 液体石蜡联合传统非手术方法干预可明显缩短粘连性肠梗阻患者病程时间,降低手术率,减少住院时间.

小肠系膜穿管支架式肠排列术治疗广泛粘连性肠梗阻

目的总结小肠系膜穿管支架式肠排列术治疗广泛粘连性肠梗阻的方法和效果。方法应用小肠系膜穿管支架式肠排列术治疗广泛粘连性肠梗阻52例,总结和评价其技术方法及效果。结果术后死亡1例;肠瘘1例。12例术后行钡餐检查,见钡剂在小肠通过顺畅有序。43例获随访（1-20年）,无肠梗阻复发。结论小肠系膜穿管支架式肠排列术操作简单、效果肯定,是治疗广泛粘连性肠梗阻的一种理想术式。

不同策略治疗粘连性小肠梗阻的临床分析

目的 通过分析不同策略治疗完全性粘连性小肠梗阻(adhesive small bowel obstruction,ASBO)的临床数据,探讨单气囊小肠镜对ASBO的疗效价值。方法 回顾性分析2013年1月至2020年12月郑州大学第一附属医院收治的完全性ASBO患者,比较手术治疗、保守治疗及单气囊小肠镜治疗的效果及预后。结果 360例完全性ASBO患者中,86例患者在入院的24 h内进行了手术治疗,剩余的274例患者接受了单气囊小肠镜治疗或保守治疗。保守治疗患者改为手术治疗的指征包括:梗阻不能缓解,临床状况恶化,或影像学改变提示病情严重。急诊手术组与延迟手术组相比,在术中发现及并发症预后方面差异无统计学意义(P>0.05)。单气囊小肠镜治疗组的总有效率显著高于保守治疗组(P<0.05)。保守治疗组、单气囊小肠镜治疗组与急诊手术组在入院白细胞及放疗病史方面差异有统计学意义(P<0.05)。结论 急诊手术在术中发现及术后并发症方面并不优于延迟手术,单气囊小肠镜是一种安全、有效的治疗ASBO的消化内镜手段。

粘连性小肠梗阻发病机制与预防进展

腹部手术后,机体在修复过程中会产生一系列生物化学与细胞学反应,导致腹腔粘连形成。尽管粘连形成具有一定保护性意义,但是粘连也是导致术后小肠梗阻的最主要病因。研究发现,纤维素沉积与降解之间的平衡关系,对于粘连性小肠梗阻的发病机制起着重要作用。

中西医结合干预粘连性肠梗阻腹腔镜松解术后效果分析

目的:观察在常规治疗与护理基础上加用中药热熨和穴位敷贴干预粘连性肠梗阻(ASBO)腹腔镜松解术后患者的效果。方法:将93例ASBO腹腔镜松解术后患者随机分为对照组46例和观察组47例。2组均在腹腔镜松解术后给予常规治疗与护理措施,观察组加用中药热熨腹部和穴位敷贴。连续观察1周。记录2组患者的术后胃肠蠕动恢复时间、下床活动时间、住院时间、胃管拔除时间、首次进食时间、术后并发症情况,评价患者对护理的满意度和依从性。结果:观察组胃肠蠕动恢复时间、下床活动时间、胃管拔除时间、首次进食时间、住院时间均较对照组缩短(P <0.05)。观察组的腹痛发生率与并发症总发生率均低于对照组(P <0.05,P <0.01)。观察组的护理满意度优于对照组(P <0.05),护理依从性高于对照组(P <0.05)。结论:在常规治疗与护理基础上加用中药热熨和穴位敷贴干预ASBO腹腔镜松解术后患者,可促进患者胃肠功能的恢复,缩短恢复时间,减少并发症发生,并能提高患者对护理的满意度和依从性。

小肠内排列术在广泛粘连性肠梗阻手术治疗的应用

目的:探讨小肠内排列术与传统肠梗阻手术治疗广泛粘连性肠梗阻的疗效差异。方法:2010年1月-2021年3月收治广泛粘连性肠梗阻患者81例,随机分为两组。给予对照组患者传统肠梗阻手术治疗,给予观察组患者肠梗阻手术联合小肠内排列手术治疗。对患者治疗效果、并发症等指标进行记录。结果:观察组患者手术过程中出血量少,且术后通气时间短、住院时间短,与对照组的对比结果显示,差异有统计学意义(P<0.05);手术时间方面,观察组更长,但观察组术后并发症发生率更低,差异均无统计学意义(P>0.05)。结论:相较于传统肠梗阻手术,小肠内排列术治疗广泛粘连性肠梗阻患者,具有操作简单,治疗效果好的优势,能明显改善患者术后指标水平,降低并发症发生率作用明显。