Comparative Effectiveness of Small Bowel Decompression Methods in Patients with Benign Small Bowel Obstruction: Results of a Multicenter Non-Randomized Controlled Retrospective Study

Introduction. The success of treatment of patients with acute intestinal obstruction is determined by many factors, including the correction of intra-abdominal hypertension and endotoxicosis by performing intraoperative decompression of the small intestine.

Aim of Study. Evaluation of the effectiveness and safety of small intestinal decompression methods in patients with benign forms of small bowel obstruction.

Material and Methods. The present work was conducted as a multicenter cohort retrospective study, including the analysis of treatment outcomes of 397 patients operated on for benign forms of intestinal obstruction, who underwent one of three types of intestinal decompression intraoperatively: placement of a gastric tube, intubation of the initial sections of the small intestine, and total intubation of the intestine. The study groups did not demonstrate significant differences in the main clinical, laboratory parameters, causes of intestinal obstruction, and intraoperative findings. Significant differences were revealed when comparing the degree of intestinal dilation and the resection nature of the intervention, that influenced both the choice of decompression method and, probably, the outcome of treatment - these parameters were taken into account as confounders.

Conclusion. Carrying out total nasogastrointestinal intubation for decompressive purposes in patients with benign forms of intestinal obstruction was associated with the highest mortality (22.3% versus 7.0% in the group with nasogastric tubes, and 13.3% in the group with short intestinal tubes, p<0.001) even in the context of the comparative predominance of resection interventions in this group of patients. As for the other methods of intraoperative intestinal decompression, the data obtained do not allow us to make an unambiguous choice between the installation of a nasogastric tube or intubation of the initial parts of the small intestine, since when taking into account the main confounders, no significant differences in the studied outcomes were found in these groups of patients. Keywords: acute intestinal obstruction, nasogastric tube, nasointestinal tube, intestinal decompression> < 0.001) even in the context of the comparative predominance of resection interventions in this group of patients. As for the other methods of intraoperative intestinal decompression, the data obtained do not allow us to make an unambiguous choice between the installation of a nasogastric tube or intubation of the initial parts of the small intestine, since when taking into account the main confounders, no significant differences in the studied outcomes were found in these groups of patients.

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