Elective Adhesiolysis vs. a Wait-and-see Policy to Prevent Recurrences After Conservative Treatment of Adhesive Small Bowel Obstruction

Launched by RADBOUD UNIVERSITY MEDICAL CENTER · Jan 10, 2025

Keywords

ClinConnect Summary

This clinical trial is studying two different approaches to prevent recurring adhesive small bowel obstruction (aSBO) in patients who have recently recovered from this condition. aSBO occurs when scar tissue from previous surgeries or injuries causes the intestines to stick together, leading to blockages. The trial will compare elective adhesiolysis, a surgical procedure that removes these adhesions, with a wait-and-see approach, which is the current standard treatment. The goal is to see if the surgical option can significantly reduce the chance of future blockages and improve patients' quality of life.

To participate in this trial, you need to be an adult aged 18 or older who has recently recovered from aSBO through conservative treatment, meaning without surgery. You should not have serious medical issues that would make surgery unsafe, and you must meet certain imaging criteria to confirm the cause of your obstruction. If you join the study, you can expect to either undergo the adhesiolysis procedure or follow the wait-and-see method, and researchers will track your health outcomes over time. This trial aims to provide insights that could help improve care for patients with this common and challenging condition.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult patients aged 18 years and older who have recently recovered from aSBO by small bowel obstruction managed by conservative treatment.
• • Patients who have previously been operated (high a prior risk of adhesions) are required to have no signs of other causes of bowel obstruction on imaging studies (CT-scan).
• • Patients with no previous operation in history (low a prior risk of adhesions) are required to have typical signs for aSBO on imaging studies (abrupt change of bowel calibre, closed loop, or signs of torsion on vessels in the mesentery on CT-scan).
• Exclusion Criteria:
• • Patient who are unfit for reoperation for surgical, anesthesiological or medical reasons as determined by multidisciplinary team assessment or pre-operative screening
• • Patients with active malignancy, reducing life expectancy
• • Pregnancy