Early Surgery Versus 3 Days of Non-surgical Care for Adults with Acute Small Bowel Obstruction

What this Trial Is About

Researchers are studying the best management approach for uncomplicated acute small bowel obstruction aSBO, a condition where the small intestine is blocked. Traditionally, non-surgical treatment lasting 72 hours is recommended before considering surgery, but this is only successful in about 60 to 70% of cases. Early surgery within 24 hours is being evaluated as it may reduce complications, hospital stay length, and improve surgical outcomes due to advances in laparoscopic techniques and anesthesia. The study compares two treatment strategies. One group receives standard care involving a nasogastric tube and hydration for 72 hours before surgery is considered if symptoms do not improve. The experimental groups treatment is guided by a radiological score that predicts treatment success patients with a high score 5 receive early surgery within 24 hours, starting laparoscopically with conversion to open surgery if needed. Those with a low score <5 receive the standard 72-hour medical management. Participants are monitored daily during their hospital stay for surgery details, medical management success, gastrointestinal recovery, and any complications. Follow-up visits occur 30 and 90 days post-surgery to track morbidity, mortality, and recurrence. Additionally, participants receive a telephone follow-up at 12 months to assess any further episodes of obstruction. The primary outcome is 90-day morbidity and mortality related to the management strategy.

Early Surgery Versus 3 Days Non-surgical Management in Acute Small Bowel Obstruction (SURGI-BOW)