{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:18:43Z","timestamp":1788304723536,"version":"build-2803163510"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":74,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The nasogastric tube (NGT) is recommended routinely by current guidelines in the non-operative management of adhesional small bowel obstruction (ASBO). However, several retrospective studies have reported poorer outcomes in ASBO patients managed with an NGT. We sought to examine current practices among Australian General Surgeons in managing ASBO and using NGTs, assess the presence of surgical equipoise for a potential randomised controlled trial (RCT), and evaluate interest in multi-centre collaboration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In October 2021, we conducted an online survey of all active members of General Surgeons Australia using a REDCap\n                      <jats:sup>\u00ae<\/jats:sup>\n                      questionnaire distributed via email. The survey included clinical scenarios of small bowel obstruction and questions on demographics, management practices, and clinical reasoning. Descriptive statistics were used to summarise all relevant variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 893 emails sent, 181 responses were received (20%). Most respondents were from New South Wales (47%) and had subspecialty training (71%). An NGT was used in over 90% of ASBO cases by 42% of respondents. 64% believed NGT use could prevent surgery, and 93% viewed it as having a therapeutic role. Vomiting was the most common indication for insertion, and 69% believed it reduces aspiration risk. Gastrografin\n                      <jats:sup>\u00ae<\/jats:sup>\n                      was used by 96% of surgeons. 42% expressed willingness to participate in an RCT evaluating NGT use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is considerable variation among surgeons in their beliefs regarding its utility. The observed variation in practice patterns and underlying beliefs reflects ongoing clinical uncertainty. Given the exploratory nature of the survey and its response rate, these findings should be interpreted as reflecting practice variability, rather than establishing consensus, and may inform the design of further investigation through a RCT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-026-03587-8","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T08:45:07Z","timestamp":1781945107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["National survey on management practices for adhesional small bowel obstruction and nasogastric tube use among general surgeons in Australia"],"prefix":"10.1186","volume":"26","author":[{"given":"Ali","family":"Al-Mashat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anaan","family":"Fareed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan","family":"Gani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"issue":"6","key":"3587_CR1","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.amjsurg.2007.04.019","volume":"195","author":"JJ Duron","year":"2008","unstructured":"Duron JJ, du Montcel ST, Berger A, Muscari F, Hennet H, Veyrieres M, Hay JM. French federation for surgical Research. Prevalence and risk factors of mortality and morbidity after operation for adhesive postoperative small bowel obstruction. Am J Surg. 2008;195(6):726\u201334. https:\/\/doi.org\/10.1016\/j.amjsurg.2007.04.019.","journal-title":"Am J Surg"},{"issue":"4","key":"3587_CR2","first-page":"291","volume":"50","author":"JAP Attard","year":"2007","unstructured":"Attard JAP, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg. 2007;50(4):291\u2013300.","journal-title":"Can J Surg"},{"key":"3587_CR3","doi-asserted-by":"publisher","first-page":"100185","DOI":"10.1016\/j.soda.2024.100185","volume":"16","author":"O Gutierrez Moreno","year":"2024","unstructured":"Gutierrez Moreno O, Arredondo Mora N, Rincon Barbosa O, Gil Quintero F. Associated factors with nonoperative management failure in bowel obstruction. Surg Open Dig Adv. 2024;16:100185. https:\/\/doi.org\/10.1016\/j.soda.2024.100185.","journal-title":"Surg Open Dig Adv"},{"issue":"1","key":"3587_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13017-018-0185-2","volume":"13","author":"RPG ten Broek","year":"2018","unstructured":"ten Broek RPG, Krielen P, Di Saverio S, Coccolini F, Biffl WL, Ansaloni L, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 2018;13(1):24. https:\/\/doi.org\/10.1186\/s13017-018-0185-2.","journal-title":"World J Emerg Surg"},{"issue":"4","key":"3587_CR5","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1002\/bjs.5775","volume":"94","author":"SM Abbas","year":"2007","unstructured":"Abbas SM, Bissett IP, Parry BR. Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction. Br J Surg. 2007;94(4):404\u201311. https:\/\/doi.org\/10.1002\/bjs.5775.","journal-title":"Br J Surg"},{"issue":"4","key":"3587_CR6","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1177\/000313481307900433","volume":"79","author":"AL Fonseca","year":"2013","unstructured":"Fonseca AL, Schuster KM, Maung AA, Kaplan LJ, Davis KA. Routine nasogastric decompression in small bowel obstruction: is it really necessary? Am Surg. 2013;79(4):422\u20138. PMID: 23574854.","journal-title":"Am Surg"},{"issue":"12","key":"3587_CR7","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1016\/j.ajem.2017.08.029","volume":"35","author":"DJ Berman","year":"2017","unstructured":"Berman DJ, Ijaz H, Alkhunaizi M, Kulie PE, Vaziri K, Richards LM, Meltzer AC. Nasogastric decompression not associated with a reduction in surgery or bowel ischemia for acute small bowel obstruction. Am J Emerg Med. 2017;35(12):1919\u201321. https:\/\/doi.org\/10.1016\/j.ajem.2017.08.029.","journal-title":"Am J Emerg Med"},{"issue":"6","key":"3587_CR8","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1016\/j.amjsurg.2021.11.029","volume":"223","author":"K Shinohara","year":"2022","unstructured":"Shinohara K, Asaba Y, Ishida T, Maeta T, Suzuki M, Mizukami Y. Nonoperative management without nasogastric tube decompression for adhesive small bowel obstruction. Am J Surg. 2022;223(6):1179\u201382. https:\/\/doi.org\/10.1016\/j.amjsurg.2021.11.029.","journal-title":"Am J Surg"},{"key":"3587_CR9","doi-asserted-by":"publisher","first-page":"e3400","DOI":"10.1590\/1518-8345.3355.3400","volume":"29","author":"APG Motta","year":"2021","unstructured":"Motta APG, Rigobello MCG, Silveira RCCP, Gimenes FRE. Nasogastric\/nasoenteric tube-related adverse events: an integrative review. Rev Lat Am Enfermagem. 2021;29:e3400. https:\/\/doi.org\/10.1590\/1518-8345.3355.3400.","journal-title":"Rev Lat Am Enfermagem"},{"key":"3587_CR10","doi-asserted-by":"publisher","unstructured":"Al-Mashat A. National survey on management practices for adhesional small bowel obstruction and nasogastric tube use among general surgeons in Australia. Br J Surg. 2025;112(Suppl 1). https:\/\/doi.org\/10.1093\/bjs\/znae318.014. znae318.014.","DOI":"10.1093\/bjs\/znae318.014"},{"issue":"11","key":"3587_CR11","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1111\/ans.14526","volume":"88","author":"J K\u00f6stenbauer","year":"2018","unstructured":"K\u00f6stenbauer J, Truskett PG. Current management of adhesive small bowel obstruction. ANZ J Surg. 2018;88(11):1117\u201322. https:\/\/doi.org\/10.1111\/ans.14526.","journal-title":"ANZ J Surg"},{"issue":"6","key":"3587_CR12","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1097\/TA.0b013e31816f709e","volume":"64","author":"JJ Diaz Jr","year":"2008","unstructured":"Diaz JJ Jr, Bokhari F, Mowery NT, Acosta JA, Block EFJ, Bromberg WJ, et al. Guidelines for management of small bowel obstruction. J Trauma. 2008;64(6):1651\u201364. https:\/\/doi.org\/10.1097\/TA.0b013e31816f709e.","journal-title":"J Trauma"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-026-03587-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-03587-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-03587-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:07:37Z","timestamp":1788304057000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12893-026-03587-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3587"],"URL":"https:\/\/doi.org\/10.1186\/s12893-026-03587-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7166930\/v1","asserted-by":"object"}]},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"20 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This research was granted approval by the Hunter New England Human Research Ethics Committee (HREC), reference 2021\/\/ETH00724. This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. Informed consent was obtained from all participants. A cover letter distributed by General Surgeons Australia stated that completing the survey via the REDCap\n                      \u00ae\n                      platform indicated consent to participate, and that responses could be used in grouped form for this and future ethically approved projects.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable as no individual identifiable data is published in this study.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"591"}}