Risk of adhesive bowel obstruction after abdominal surgery. A national cohort study of 665,423 Danish women |
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| Authors: | Christina Norrbom Marianne Steding-Jessen Carsten Thye Agger Merete Osler Marie Krabbe-Sorensen Annette Settnes Lisbeth Nilas Ellen Christine Leth Loekkegaard |
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| Institution: | 1. Department of Obstetrics and Gynecology, North Zealand Hospital Hilleroed, Dyrehavevej 29, 3400, Hilleroed, Denmark;2. The Danish Clinical Registries, Department. for Cancer and Cancer Screening, Central Region of Denmark, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;3. Center for Clinical Research and Disease Prevention, Frederiksberg and Bispebjerg Hospitals, Denmark, Hovedvejen, indgang 5, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;4. Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postboks 2099, 1014, København K, Denmark;5. Stork Fertility Clinique, Copenhagen, Store Kongensgade 40H, 1. sal, 1264, København K, Denmark;6. Gynecological Department, Hvidovre Hospital, Denmark |
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| Abstract: | BackgroundAdhesive bowel obstruction is associated with considerable morbidity and mortality, but the magnitude of the risk is debated.MethodIn a national cohort of all Danish women with an abdominal operation (N?=?665,423) between 1977 and 2013, the risk of adhesive bowel obstruction was assessed by Cox multiple regression. Covariates were the number of abdominal operations, the surgical methods, the anatomical site involved, and the calendar year.ResultsIn the cohort, 1.4% experienced an episode of adhesive bowel obstruction. The risk increased 33–43% during the study period, was lower after gynecological and obstetrical procedures compared to gastrointestinal (HR 0.36 0.34–0.38]), lower after laparoscopic compared to laparotomic surgery (HR 0.51 0.48–0.54]) and increased proportionally after each additional operation.ConclusionsThe risk of adhesive bowel obstruction after abdominal operations depends on the site of earlier operations, the method of access and the number of earlier operations. |
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| Keywords: | Adhesive bowel obstruction Surgery Adhesions Cohort study |
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