198 Chapter 8 This shorter duration of follow-up for laparoscopies partly explains our shorter median duration of follow-up compared to previous studies, which is this study’s largest limitation. Adhesions have caused obstruction up to 28 years after surgery showing the importance of long-term follow-up [5]. Still, it seems that in most studies a two year follow-up results in the inclusion of most SBOs, which is why future prospective studies should aim to achieve a follow-up of two years, as was suggested by other authors, including patients that underwent laparoscopy (2, 4-7, 12). Our subgroup analysis into patients who had at least a follow-up of two years showed an increase in the incidence of SBO to 7%. This increase could, however, have other explanations. Patients with less extensive surgery or patients who don’t necessitate a stoma have a shorter follow-up and thereby have a lower chance of SBO. Moreover, our Kaplan-Meier curve showed that most patients treated for NEC or gastroschisis experienced an SBO within the first half year of follow-up. This suggests that at least in some (high risk) diseases a shorter time of follow-up might be feasible. This study shows that the morbidity of SBO following abdominal surgery in young children is common. Awareness of the high risk diseases and risk factors may provide a basis for the research into changes in surgical practice aiming to decrease SBO occurrence. Acknowledgements We would like to thank Shaffy Roell for proof reading and language assistance.
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