Short and Prolonged Conservative Treatment in Patients With Adhesive Intestinal Obstruction

North-Western State Medical University (NWSMU)

Status: Enrolling

Conditions: Small Bowel Obstruction; Small Bowel Adhesion

Treatments: Procedure: Adhesiolysis; Procedure: Conservative treatment; Radiation: X-ray examination

Study type: Interventional

Funder types: Other

Identifiers

NCT05841069

24121989

Details and patient eligibility

About

This study will compare the results of 24 h conservative treatment and N h conservative treatment of adhesive small bowel obstruction (where N = 72 h minus duration of intestinal obstruction).

Full description

Patients with acute adhesive intestinal obstruction, who dont need an emergency operation, will be given water insoluble contrast per os and randomized into two groups - early and delayed surgery. The first group will receive conservative treatment within no more than 24 h. Duration of non-operative treatment in second group will be 72 h minus duration of intestinal obstruction, based on the onset of symptoms. In both groups surgery will be performed if contrast will not reach colon in mentioned terms or clinical deterioration signs will appear. The results of 24 h conservative treatment and N h conservative treatment (where N = 72 h minus duration of intestinal obstruction) will be compared.

Enrollment: 180 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients with acute intestinal obstruction

Exclusion criteria

• pregnancy;
• peritonitis or strangulation, revealed during primary examination;
• early acute small bowel obstruction (presence of anamnestic surgical intervention within 6 month)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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180 participants in 2 patient groups

Short conservative treatment

Active Comparator group

Description:

Conservative treatment will be performed within no more than 24 h. Surgery will be performed in the absence of contrast in colon according to X-ray examination and if signs of clinical degradation will appear.

Treatment:

Radiation: X-ray examination

Procedure: Adhesiolysis

Procedure: Conservative treatment

Prolonged conservative treatment

Experimental group

Description:

Conservative treatment will be performed within N h, where N = 72 h minus duration of acute intestinal obstruction. Surgery will be performed in the absence of contrast in colon according to X-ray examination and if signs of clinical degradation will appear.

Treatment:

Radiation: X-ray examination

Procedure: Adhesiolysis

Procedure: Conservative treatment