Our Summary

This study looked at emergency surgeries involving the small intestine, specifically examining whether it’s safer for doctors to sew the intestine back together (anastomosis) or create an opening for waste to leave the body (enterostomy) after removing a portion of the intestine. The researchers reviewed surgeries at a Danish university hospital from 2016 to 2019. They found that most of the time (about 85%), doctors chose to sew the intestine back together. The death rate within 30 days of surgery was lower for patients who had their intestines sewn back together (10.2%) compared to those who had an opening created (26.3%). The rate of leaks at the sewn-together site was very low. Therefore, sewing the intestine back together in emergency situations seems to be a safe and effective method.

FAQs

  1. What were the two methods of treatment discussed in the study regarding surgeries involving the small intestine?
  2. Based on the study, which method had a lower death rate within 30 days of surgery?
  3. How common were leaks at the site where the intestine was sewn back together according to the research?

Doctor’s Tip

One helpful tip a doctor might tell a patient about bowel resection is to follow post-operative care instructions carefully, including taking prescribed medications, eating a healthy diet, and avoiding strenuous activities to promote healing and prevent complications. It is also important to attend all follow-up appointments with your healthcare provider to monitor your recovery progress.

Suitable For

Patients who are typically recommended for bowel resection include those with conditions such as:

  1. Intestinal blockage or obstruction
  2. Cancerous or noncancerous tumors in the intestines
  3. Crohn’s disease or ulcerative colitis
  4. Diverticulitis
  5. Intestinal perforation or rupture
  6. Intestinal inflammation or infection

In emergency situations, such as those mentioned in the study above, patients who require immediate surgical intervention for conditions like intestinal obstruction or perforation may also be recommended for bowel resection.

Timeline

Before bowel resection:

  1. Patient experiences symptoms such as abdominal pain, bloating, changes in bowel habits, and possibly bleeding.
  2. Patient undergoes diagnostic tests such as imaging studies and colonoscopy to determine the cause of their symptoms.
  3. Once a diagnosis is made, the patient and their healthcare team discuss treatment options, including the possibility of bowel resection surgery.
  4. Patient may undergo preoperative preparations such as bowel cleansing and fasting.
  5. Surgery is scheduled, and the patient undergoes bowel resection to remove the affected portion of the intestine.

After bowel resection:

  1. Patient wakes up from surgery in the recovery room and is closely monitored for any complications.
  2. Patient is gradually allowed to start eating and drinking again, starting with clear liquids and progressing to solid foods.
  3. Patient may experience pain, discomfort, and fatigue in the days following surgery.
  4. Patient is monitored for signs of infection, bowel obstruction, or other complications.
  5. Once the patient is stable, they are discharged from the hospital and instructed on how to care for their surgical incision and manage pain at home.
  6. Patient may need to follow a special diet temporarily to allow the intestine to heal properly.
  7. Patient has follow-up appointments with their healthcare team to monitor their recovery and address any concerns.

What to Ask Your Doctor

  1. What is a bowel resection and why do I need it?
  2. What are the risks and potential complications of the surgery?
  3. What are the benefits of sewing the intestine back together versus creating an opening for waste to leave the body?
  4. How long is the recovery period and what can I expect during that time?
  5. Will I need any additional treatments or therapies after the surgery?
  6. What is the success rate of the surgery in terms of long-term outcomes?
  7. How will my diet and lifestyle need to change after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication after the surgery?
  9. Are there any alternatives to bowel resection that I should consider?
  10. How many times have you performed this type of surgery and what is your success rate?

Reference

Authors: Skovsen AP, Korgaard Jensen T, Gögenur I, Tolstrup MB. Journal: World J Surg. 2024 Feb;48(2):341-349. doi: 10.1002/wjs.12059. Epub 2024 Jan 4. PMID: 38686800