Small Bowel AdhesionAIO-S/AAPNCT07905300
Intestinal Obstruction Surgery. Acute Abdominal Pathology. №9:05/05/2026
An observational study of Small Bowel Adhesion and Obstruction Bowel, run by Astana Medical University at 1 site in Kazakhstan.
Trial summary
Abstract and Study Objectives Adhesive small bowel obstruction (ASBO) is a common indication for surgical intervention. Intra-abdominal adhesions are the leading cause of small bowel obstruction, particularly in patients with a history of previous abdominal surgery, which has been reported in up to 70-80% of cases. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Small Bowel Adhesion, Obstruction Bowel, Adhesiolysis
- What is being tested?
- surgical operation
- Type of treatment
- Surgery or procedure
- How many people
- 1,500 participants
- Where
- 1 siteKazakhstan
- Study dates
- 30 Jan 2024to May 2029
- How long will I take part?
- 5 Years
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study will be conducted at the national multicenter level, in regional (provincial) clinics among patients admitted on an emergency basis to surgical hospitals, including university clinics.
Who may be able to join
None listed.
Who cannot join
- Severe and septic clinical peritonitis, indicating urgent intervention
- Confirmed or suspected peritoneal carcinosis
- Previous open surgery for endometriosis
- Active malignancy diagnosed or in remission of the abdominal cavity for less than 10 years
- Radiation therapy to an earlier abdominal region 4 or more previous open abdominal surgeries (excluding cesarean section)
- Suspected other cause Obstructions other than adhesions on CT
Show all 10Show fewer
- Previous surgery on the aorta or iliac vessels via laparotomy
- Crohn's disease
- Anesthetic contraindication for laparoscopy
- Lack of informed consent Age under 18 or over 90 years Pregnancy over 12 weeks
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Intestinal Obstruction Surgery. Acute Abdominal Pathology.
Abstract and Study Objectives Adhesive small bowel obstruction (ASBO) is a common indication for surgical intervention. Intra-abdominal adhesions are the leading cause of small bowel obstruction, particularly in patients with a history of previous abdominal surgery, which has been reported in up to 70-80% of cases.
Read the detailed description
Treatment strategies for small bowel obstruction depend on the clinical presentation and several patient- and disease-related factors, including the severity and duration of symptoms, the number of previous surgical procedures, comorbidities, and metabolic disorders. Clearer criteria are needed to determine which patients can be managed non-operatively, either in an outpatient or inpatient setting, and which require surgical intervention. Nevertheless, surgery may be necessary in up to 60% of cases.
Currently, there is no universally accepted surgical approach to adhesive small bowel obstruction, and the optimal role of open adhesiolysis versus laparoscopic adhesiolysis remains unclear. Our retrospective studies have shown encouraging results with laparoscopic adhesiolysis. However, prospective randomized studies remain limited, and the available evidence is insufficient to establish definitive treatment strategies, particularly in emergency and complex clinical situations. National-level analyses are also lacking, while some retrospective case series are subject to a substantial risk of selection bias and other methodological limitations.
Available clinical observations suggest that laparoscopic adhesiolysis may offer several advantages, including a shorter hospital stay and a potentially lower risk of readmission. Its minimally invasive nature may reduce postoperative pain and could potentially improve clinical outcomes. However, laparoscopic adhesiolysis carries a risk of inadvertent intraoperative bowel injury, including iatrogenic injury to the small intestine.
The primary aim of this study is to identify diagnostic and treatment strategies for patients presenting with adhesive small bowel obstruction in outpatient and inpatient settings by evaluating predictors of disease severity and treatment outcomes and subsequently developing an evidence-based surgical management algorithm.
The secondary objectives are:
- To identify clinical and diagnostic criteria for selecting patients for non-operative management or surgical intervention.
- To determine the indications for open surgery and to evaluate the appropriate role of single-port and multiport laparoscopic approaches.
- To investigate the influence of comorbidities, including cardiovascular disease, thromboembolic conditions, metabolic disorders, obesity, and diabetes mellitus, on treatment selection and clinical outcomes.
- To compare the outcomes of open adhesiolysis and laparoscopic adhesiolysis. The study hypothesis is that laparoscopic adhesiolysis, when performed in appropriately selected patients, may be associated with better clinical outcomes than open adhesiolysis. The study will also investigate whether the use of additional imaging techniques and methods for more accurate localization of adhesions can improve surgical planning and outcomes. Specifically, we hypothesize that laparoscopic adhesiolysis may be associated with a shorter hospital stay, fewer intraoperative and postoperative complications, and lower mortality compared with the open approach.
- Conditions
- Small Bowel Adhesion, Obstruction Bowel, Adhesiolysis, Laparoscopic Abdominal Surgeries, Adhesion Prevention (Abdominal), Triage
- Being tested
- surgical operation
- Medical subject headings
- Intestinal Obstruction
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
surgical operationProcedure or surgery
Also called Laparoscopy
Surgical intervention
| Study group | Role | What they receive |
|---|---|---|
| Laparoscopic multiport group | Laparoscopic Receives: Procedure: surgical operation | |
| Laparoscopic single-port group | Laparoscopic Receives: Procedure: surgical operation | |
| Laparotomy group | Laparotomy Receives: Procedure: surgical operation |
What is being measured
The primary outcome is the main question the study is designed to answer.
removal of adhesions, reduction of pain, recurrence of the disease and recovery
The frequency and location of adhesions in the abdominal cavity will be compared Pain, its intensity, and duration will be studied Patient physical activity after surgery Duration and frequency of intestinal paresis Frequency of compartment syndrome
Measured: From enrollment to the end of treatment at 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Oct 2026
- Study start30 Jan 2024
- Primary completion30 Jan 2029 (estimated)
- Study completionMay 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Small Bowel AdhesionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,500 participants (estimated)
- Target duration
- 5 Years
Sponsor and investigators
- Lead sponsor
- Astana Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Fursov Alexandr, Astana Medical University
- Investigators
- Alexandr Fursov, MD, DMSc, prof., Study director, Astana Medical UniversityRoman Fursov, MD, PhD, docent, Study chair, Astana Medical UniversityNurzhan Klyshbekov, Master of Science in Medicine,, Study chair, Astana Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07905300
- Sponsor's protocol ID
- Loc bioethics commission №9
- Acronym
- AIO-S/AAP
- Status last verified
- Oct 2026
- First submitted
- 21 Oct 2026
- Last updated
- 29 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: The IPD cannot be provided temporarily, as patient registration is preliminary and data collection and analysis are ongoing. The final decision on shared use, as well as the source and amount of funding, will be made based on the analysis results.
Study at a glance
From the registry record, last updated by the sponsor on 29 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Intestinal Obstruction Surgery. Acute Abdominal Pathology.
- ClinicalTrials.gov ID
- NCT07905300
- Acronym / sponsor ID
- AIO-S/AAP / Loc bioethics commission №9
- Conditions
- Small Bowel Adhesion, Obstruction Bowel, Adhesiolysis, Laparoscopic Abdominal Surgeries, Adhesion Prevention (Abdominal), Triage
- Study type
- Observational
- Recruitment status
- Enrolling by invitation
- Enrolment
- 1,500 participants (estimated)
- Lead sponsor
- Astana Medical UniversityUniversity, hospital or other
- Study start
- 30 Jan 2024 (actual)
- Primary completion
- 30 Jan 2029 (estimated)
- Study completion
- May 2029 (estimated)
- First posted
- 29 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Abstract and Study Objectives Adhesive small bowel obstruction (ASBO) is a common indication for surgical intervention. Intra-abdominal adhesions are the leading cause of small bowel obstruction, particularly in patients with a history of previous abdominal surgery, which has been reported in up to 70-80% of cases.
Detailed description
Treatment strategies for small bowel obstruction depend on the clinical presentation and several patient- and disease-related factors, including the severity and duration of symptoms, the number of previous surgical procedures, comorbidities, and metabolic disorders. Clearer criteria are needed to determine which patients can be managed non-operatively, either in an outpatient or inpatient setting, and which require surgical intervention. Nevertheless, surgery may be necessary in up to 60% of cases.
Currently, there is no universally accepted surgical approach to adhesive small bowel obstruction, and the optimal role of open adhesiolysis versus laparoscopic adhesiolysis remains unclear. Our retrospective studies have shown encouraging results with laparoscopic adhesiolysis. However, prospective randomized studies remain limited, and the available evidence is insufficient to establish definitive treatment strategies, particularly in emergency and complex clinical situations. National-level analyses are also lacking, while some retrospective case series are subject to a substantial risk of selection bias and other methodological limitations.
Available clinical observations suggest that laparoscopic adhesiolysis may offer several advantages, including a shorter hospital stay and a potentially lower risk of readmission. Its minimally invasive nature may reduce postoperative pain and could potentially improve clinical outcomes. However, laparoscopic adhesiolysis carries a risk of inadvertent intraoperative bowel injury, including iatrogenic injury to the small intestine.
The primary aim of this study is to identify diagnostic and treatment strategies for patients presenting with adhesive small bowel obstruction in outpatient and inpatient settings by evaluating predictors of disease severity and treatment outcomes and subsequently developing an evidence-based surgical management algorithm.
The secondary objectives are:
- To identify clinical and diagnostic criteria for selecting patients for non-operative management or surgical intervention.
- To determine the indications for open surgery and to evaluate the appropriate role of single-port and multiport laparoscopic approaches.
- To investigate the influence of comorbidities, including cardiovascular disease, thromboembolic conditions, metabolic disorders, obesity, and diabetes mellitus, on treatment selection and clinical outcomes.
- To compare the outcomes of open adhesiolysis and laparoscopic adhesiolysis. The study hypothesis is that laparoscopic adhesiolysis, when performed in appropriately selected patients, may be associated with better clinical outcomes than open adhesiolysis. The study will also investigate whether the use of additional imaging techniques and methods for more accurate localization of adhesions can improve surgical planning and outcomes. Specifically, we hypothesize that laparoscopic adhesiolysis may be associated with a shorter hospital stay, fewer intraoperative and postoperative complications, and lower mortality compared with the open approach.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 5 Years
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Laparoscopic multiport group | – | Procedure: surgical operationLaparoscopic |
| Laparoscopic single-port group | – | Procedure: surgical operationLaparoscopic |
| Laparotomy group | – | Procedure: surgical operationLaparotomy |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study will be conducted at the national multicenter level, in regional (provincial) clinics among patients admitted on an emergency basis to surgical hospitals, including university clinics.
Key inclusion criteria (0 listed)
Key exclusion criteria (10 listed)
- Severe and septic clinical peritonitis, indicating urgent intervention
- Confirmed or suspected peritoneal carcinosis
- Previous open surgery for endometriosis
- Active malignancy diagnosed or in remission of the abdominal cavity for less than 10 years
- Radiation therapy to an earlier abdominal region 4 or more previous open abdominal surgeries (excluding cesarean section)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| surgical operationAlso: LaparoscopySurgical intervention | Procedure or surgery | Laparoscopic multiport group, Laparoscopic single-port group, Laparotomy group |
Primary outcome
removal of adhesions, reduction of pain, recurrence of the disease and recovery
Time frame: From enrollment to the end of treatment at 12 months
The frequency and location of adhesions in the abdominal cavity will be compared Pain, its intensity, and duration will be studied Patient physical activity after surgery Duration and frequency of intestinal paresis Frequency of compartment syndrome
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Oct 2026.
- Individual participant dataSharing planned: Undecided. The IPD cannot be provided temporarily, as patient registration is preliminary and data collection and analysis are ongoing. The final decision on shared use, as well as the source and amount of funding, will be made based on the analysis results.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Alexandr Fursov, MD, DMSc, prof. study director
Astana Medical University
Roman Fursov, MD, PhD, docent study chair
Astana Medical University
Nurzhan Klyshbekov, Master of Science in Medicine, study chair
Astana Medical University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Small Bowel Adhesion and Obstruction Bowel, run by Astana Medical University at 1 site in Kazakhstan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Kazakhstan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
removal of adhesions, reduction of pain, recurrence of the disease and recovery (time frame: From enrollment to the end of treatment at 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2026.