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Risk prediction model for adhesive intestinal obstruction after laparoscopic appendectomyLaparoscopic surgery for appendicitis may raise risk of future bowel blockage

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Key Takeaway
Consider that prolonged disease duration, SIRS, elevated WBC/NLR, and low albumin may be associated with adhesive intestinal obstruction after laparoscopic appendectomy.

This retrospective cohort study included 298 patients with acute appendicitis who underwent laparoscopic surgery. The study aimed to develop a risk prediction model for adhesive intestinal obstruction (AIO) by comparing patients who developed AIO (AIO group) with those who did not (non-AIO group).

Results showed that disease duration was significantly longer in the AIO group compared with the non-AIO group (p < 0.05). The prevalence of systemic inflammatory response syndrome (SIRS) was higher in the AIO group, and white blood cell count (WBC) and neutrophil-to-lymphocyte ratio (NLR) were elevated. Albumin (ALB) levels were lower in the AIO group. All differences were statistically significant (p < 0.05).

No specific effect sizes or absolute numbers were reported for these outcomes. Follow-up was conducted via telephone, but the duration was not specified. Safety and tolerability data were not reported.

Limitations include the retrospective design, lack of reported effect sizes, and absence of multivariable adjustment details. The study does not establish causality. Clinicians should interpret these findings cautiously until validated in prospective cohorts.

Many people need surgery for acute appendicitis. A recent look at 298 patients who had laparoscopic surgery for this condition found something worrying. These patients were more likely to develop adhesive intestinal obstruction later on. This is a blockage caused by scar tissue forming inside the belly. The study compared these patients to others who did not have this specific blockage issue.

The analysis showed clear differences in health markers. Patients with the future blockage had longer illness duration. They also had higher rates of systemic inflammatory response syndrome. Their white blood cell counts were elevated. The neutrophil-to-lymphocyte ratio was increased. Albumin levels were lower in this group. All these differences were statistically significant.

Researchers used telephone follow-ups to track these patients over time. The goal was to build a risk prediction model. This helps doctors spot who might need extra monitoring. However, the study was retrospective. It looked back at past records. This means we cannot say the surgery caused the blockage for sure. More research is needed to confirm these findings before changing how we treat patients.

What this means for you:
Laparoscopic appendicitis surgery linked to higher risk of future bowel blockage in some patients.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedMay 2026
View Original Abstract ↓
BackgroundAdhesive intestinal obstruction (AIO) is a recognized complication following laparoscopic surgery for acute appendicitis (AA), although its overall incidence remains relatively low. This study aimed to develop a risk prediction model based on clinical characteristics and laboratory indicators to facilitate early identification and prevention of postoperative AIO.MethodsIn this retrospective cohort study, 298 AA patients who underwent laparoscopic surgery between January 2020 and November 2024 were enrolled. Patients were categorized into AIO (n = 32) and non-AIO (n = 266) groups. Data were collected from electronic medical records and telephone follow-ups. Univariate analysis compared clinical and laboratory variables between groups. Significant variables underwent collinearity analysis, and those without collinearity were entered into binary logistic regression to identify independent predictors. A nomogram prediction model was constructed and internally validated using bootstrap resampling. Model performance was assessed using calibration curves and the area under the receiver operating characteristic curve (AUC).ResultsCompared with the non-AIO group, the AIO group exhibited significantly longer disease duration, a higher prevalence of systemic inflammatory response syndrome (SIRS), elevated white blood cell count (WBC), increased neutrophil-to-lymphocyte ratio (NLR), and lower albumin (ALB) levels (p 1, p 
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