Primary prevention

Although there is no reliable strategy to prevent the occurrence of intra-abdominal adhesions (the most common cause of SBO) after abdominal surgery, best surgical practice may minimise their formation.[8] There are also a variety of agents designed to limit the extent of adhesion formation,[9] although their efficacy is controversial. For example, the use of gels and hydroflotation agents during gynaecological surgery appears to be effective at preventing adhesion, but there is no evidence that these interventions improve fertility outcomes or pelvic pain.[10] The Royal College of Surgeons of England advises against the routine use of anti-adhesion products after surgery for adhesional obstruction.[4][11]

The diagnosis and correction of malrotation can significantly prevent the development of SBO due to intestinal volvulus.[12] Treatment of Crohn's disease and surgical correction of hernias can also limit its development. One of the potential advantages of laparoscopic surgery compared with open colorectal surgery is a reduction in postoperative bowel obstruction events. A meta-analysis showed that laparoscopic surgery for colorectal disease reduces overall early postoperative bowel obstruction, including ileus, as well as early bowel obstruction in subgroups of patients having surgery for cancer and diverticular disease.[5]

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