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Among patients with small bowel obstruction (SBO) related to adhesions, surgery usually is reserved for those whose symptoms progress during an initial trial of nonsurgical management. In this retrospective study from Ontario, Canada, researchers used province-wide administrative health data to examine rates of recurrence after surgical and nonsurgical management of a first episode of adhesive SBO.
About 6000 adults whose first episode was treated only nonoperatively were compared with 6000 propensity-score–matched patients who underwent surgery during their first hospital admission. During median follow-up of 3.6 years, recurrence rates were significantly lower in the surgical group than in the nonsurgical group (13% vs. 21%). In patients w…