Laparoscopic Management for Small Bowel Obstruction: Experience From a UK District General Hospital With One-Year Follow-Up
Bibliographic record
Abstract
Background: Small bowel obstruction (SBO) is a common surgical emergency usually treated via standard laparotomy. But with the advancement of laparoscopic surgical skills, more surgeons are undertaking laparoscopic approach as well to treat uncomplicated SBO. We aimed to compare outcomes following laparoscopic vs. open surgical techniques in a district general hospital. Methods: A retrospective review of case notes of patients who underwent operative surgical treatment for SBO between January 2012 and July 2018 was carried out. Mann-Whitney U test was used for nominal data and Chi-square test for categorical data analysis. Results: A total of 99 surgical procedures were carried out for SBO during this period at our district general hospital with 31 laparoscopic and 68 open procedures. Fifteen out of 31 were completed laparoscopically (totally laparoscopic approach (TLA)), while 16/31 were converted to open procedure (laparoscopic-assisted group (LAG)) to complete the operation. Median age for open group was 69 years (26 - 91 years) vs. 71 years (23 - 94 years) for laparoscopic group. Median length of stay was 10 vs. 6.5 days for single band adhesions treated laparoscopically (P = 0.02). Median Charlson comorbidity index was 6 vs. 5 (TLA). Eight out of 31 in laparoscopic group had complications, whereas 27/68 in open group (P = 0.26). The 30-day mortality was 5/68 for open vs. none for laparoscopy group. The 1-year follow-up for all patients confirmed 7/68 in open vs. 1/31 laparoscopic group mortalities. Conclusion: Laparoscopic surgical approach for SBO seems to have statistically significant lower small bowel resection rate and length of stay in this hospital when compared to laparotomy in selected patients. J Curr Surg. 2021;11(1):1-7 doi: https://doi.org/10.14740/jcs430
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".