Efectividad de cirugía electiva versus cirugía de urgencia en el manejo de la obstrucción intestinal por adherencias: revisión sistemática

Abstract

Background: Intestinal obstruction due to adhesions represents one of the most frequent complications, with an incidence that varies around 30%; therefore, its management remains a challenge, particularly when deciding between elective surgical intervention and emergency surgery. While emergency surgery is associated with a higher risk of perioperative complications, elective surgery may allow patient optimization, but with a potential increase in morbidity and mortality due to delayed treatment. Objective: To evaluate the effectiveness of elective surgery versus emergency surgery in the management of intestinal obstruction due to adhesions. Methods: This systematic review will follow the PRISMA 2020 guidelines, which will help ensure the quality of this review. In addition, different health-related determinants will be used to conduct an exhaustive search for information. Results: Elective surgery demonstrated higher effectiveness with 74.3% therapeutic success versus 25.7% failure requiring emergency intervention, a reduction of perioperative complications (54% vs 46%), lower surgical recurrence (11–30% vs 21–50% in multiple emergency surgeries), and significantly reduced hospital stay, which doubles in emergency surgeries, with an average of 13.8 days. These findings confirm superior effectiveness of elective surgery in stable patients without intestinal ischemia, although both procedures present specific risks that must be individualized clinically. Keywords: adhesions, emergency surgery, intestinal obstruction