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1%) underwent operative management 70% bypass, 24% stoma formation and 6% open-close laparotomies. Log rank testing of survival probability analysis was significant ( = 0.00018), with 50% survival probability at 107.32 days for operative management and 47.87 days for non-operative. Operative management forms part of the treatment pathway for a significant proportion of patients with mSBO, offering a survival benefit, though quality of survival is not known. Case selection is good, with few open-close laparotomies. Trials of non-operative intervent