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Comment & Response
July 24, 2019

Adhesive Small-Bowel Obstruction—Surgery for All?

Author Affiliations
  • 1Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
JAMA Surg. 2019;154(11):1075-1076. doi:10.1001/jamasurg.2019.2306

To the Editor We have read with great interest the article titled, “Association of Surgical Intervention for Adhesive Small-Bowel Obstruction With the Risk of Recurrence” by Behman et al.1 In this well-written study, the authors attempted to address a common challenge in every surgeon’s practice—management of patients with adhesive small-bowel obstruction (aSBO). The authors included a very large cohort of patients (N = 27 904) who were admitted with aSBO and evaluated their risk of recurrent episodes according to the chosen management at the index admission. Of the entire cohort, 22% underwent surgery during their first admission. Patients who were treated nonoperatively had an increased overall risk of recurrence compared with surgically treated patients (21.3% vs 13.0%, respectively). The authors conclude that these data contradict the notion that surgery for aSBO increases the recurrence rates and that the reduced recurrence rates with the surgical approach should be considered in the management of this patient population.

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