Our Summary

This research paper is about the results of a study comparing two methods of handling severe abdominal trauma that requires part of the intestine to be removed: either leaving the bowel disconnected or reconnecting the ends (anastomosis). The researchers looked at data from 167 patients at three different Level-1 trauma centers. They found that 84 patients had their intestines reconnected, while 83 were left disconnected.

The researchers then compared the outcomes of the two groups, looking at things like infection rates, bowel death due to lack of blood supply (ischemia), and patient death. They found that the group that was left disconnected had a higher rate of bowel ischemia than the group that was reconnected. There was also a slightly higher death rate in the disconnected group, but this was not statistically significant.

Infection rates and instances of the reconnected bowel leaking were similar between the two groups. The researchers conclude that leaving the bowel disconnected after surgery might lead to a higher risk of bowel death due to lack of blood supply. They recommend further studies to confirm these findings.

FAQs

  1. What were the two methods of handling severe abdominal trauma that the study compared?
  2. According to the study, which group had a higher rate of bowel ischemia and death?
  3. Did the study find any difference in infection rates and instances of leaking in the reconnected bowel between the two groups?

Doctor’s Tip

A doctor may advise a patient who is undergoing bowel resection to follow their post-operative care instructions closely, including maintaining a healthy diet, staying hydrated, and taking any prescribed medications as directed. They may also recommend avoiding heavy lifting or strenuous activity until fully healed to reduce the risk of complications. Additionally, they may suggest attending follow-up appointments to monitor recovery progress and address any concerns promptly.

Suitable For

Patients who are typically recommended bowel resection are those with severe abdominal trauma, bowel obstructions, bowel perforations, inflammatory bowel disease, colorectal cancer, diverticulitis, and other conditions that affect the intestines. These patients may experience symptoms such as severe abdominal pain, bloody stools, bowel perforation, bowel obstruction, and other complications that may require surgical intervention.

In the study mentioned above, patients with severe abdominal trauma were the focus of the research. The decision to reconnect or leave the bowel disconnected after resection depends on various factors such as the extent of the injury, the condition of the remaining bowel, and the overall health of the patient. The results of the study suggest that reconnecting the bowel may reduce the risk of bowel ischemia and possibly improve outcomes for these patients.

Ultimately, the decision to recommend bowel resection and the method of handling the resected bowel will depend on the individual patient’s specific condition and the recommendations of their healthcare provider.

Timeline

Before bowel resection:

  1. Patient presents with severe abdominal trauma or disease that requires part of the intestine to be removed.
  2. Patient undergoes pre-operative evaluations and tests to determine the extent of the bowel resection needed.
  3. Surgery is performed to remove the damaged or diseased portion of the intestine.

After bowel resection:

  1. Patient undergoes post-operative care, including monitoring for complications such as infection and bowel ischemia.
  2. Depending on the surgical approach, the intestine may be either reconnected (anastomosis) or left disconnected.
  3. Patient is monitored for signs of complications, such as bowel leakage or further ischemia.
  4. Follow-up appointments are scheduled to assess the healing process and overall recovery.

Overall, the patient may experience a period of recovery and adjustment following bowel resection, with potential risks and complications depending on the surgical approach and individual health factors.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bowel resection surgery?
  2. What factors will determine whether my intestines will be left disconnected or reconnected during the surgery?
  3. What is the expected recovery time and post-operative care following bowel resection surgery?
  4. How will my diet and bowel movements be affected after the surgery?
  5. What signs or symptoms should I watch for that may indicate a complication following the surgery?
  6. Are there any long-term effects or complications that I should be aware of?
  7. Will I need any additional follow-up procedures or tests after the surgery?
  8. What is the success rate for bowel resection surgery in terms of resolving my medical condition?
  9. Are there any lifestyle changes or precautions I should take after the surgery to prevent future complications?
  10. Are there any alternative treatment options to consider before proceeding with bowel resection surgery?

Reference

Authors: Talving P, Chouliaras K, Eastman A, Lauerman M, Teixeira PG, DuBose J, Minei J, Scalea T, Demetriades D. Journal: World J Surg. 2017 Jan;41(1):146-151. doi: 10.1007/s00268-016-3685-9. PMID: 27541027