Early Intervention on Small Bowel Obstruction. Is There Time to Wait?

Background: Timely surgical intervention is essential for optimizing outcomes in Adhesive Small Bowel Obstruction (ASBO) cases.This study evaluated the relationship between the timing of surgery and patient outcomes, focusing on hospital length of stay (LOS) and postoperative complications.Methods: A retrospective analysis included 2,210 ASBO patients undergoing surgery, grouped by time from admission to surgery: urgent (<12 hours), early (12-24 hours), and delayed (>24 hours).Outcomes assessed were postoperative complications, LOS, reoperation rates, and approach (laparoscopic vs. open).Results: Of the patients, 63% underwent delayed surgery (>24 hours), 19% early surgery (12-24 hours), and 18% urgent surgery (<12 hours).Delayed surgery was linked to longer LOS (4.48 days) than urgent (0.95 days; p<0.001) or early surgery (1.25 days; p<0.001).Laparoscopic surgery had fewer complications than open surgery (11.4% vs. 20.1%,OR 0.69, p=0.001).Delayed surgery and older age were associated with higher reoperation rates (OR 1.82, p=0.049;OR 1.02, p=0.007).Postoperative complications were twice as high for surgeries after 12 hours (24.6%) compared to within 12 hours (11.4%, p=0.005). Conclusion:Delayed surgery in ASBO patients correlates with longer LOS and higher complication rates.Laparoscopic surgery, appears to reduce complications, emphasizing the benefit of early intervention in ASBO management.