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Long intestinal tube splinting prevents postoperative adhesive small-bowel obstruction in sclerosing encapsulating peritonitis.

Li M, Zhu W, Li Y, Jiang J, Li J, Li N - BMC Gastroenterol (2014)

Bottom Line: The rate of complications was 9.1% and 6.1% in the simple enterolysis group and tube-splinting group, respectively (P = 0.73).The recurrence rate of ASBO was lower in the tube-splinting group (6.7%) than in the simple enterolysis group (40%) (P = 0.02).Our findings indicate that tube splinting may be more useful than simple enterolysis alone in preventing the recurrence of ASBO in patients with SEP.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling Hospital, Medicine School of Nanjing University, NO 305 East Zhongshan Road, Nanjing, Jiangsu Province, China. liningrigs@vip.sina.com.

ABSTRACT

Background: Sclerosing encapsulating peritonitis (SEP) is a rare cause of small-bowel obstruction. The optimal treatment for this condition remains controversial.

Methods: In this study, we performed a retrospective analysis of the data of 44 patients who underwent surgery for SEP between December 2001 and 2008 at our hospital. The long-term follow-up data of the patients were assessed for the recurrence of adhesive small-bowel obstruction (ASBO), and patient survival was assessed to evaluate the efficiency of tube splinting in the prevention of postoperative ASBO.

Results: Of the 44 patients who underwent surgery for SEP, 33 underwent simple enterolysis along with tube splinting, while the remaining underwent only simple enterolysis. The median follow-up period was 79.4 ± 24.8 months (range: 8-123 months). The rate of complications was 9.1% and 6.1% in the simple enterolysis group and tube-splinting group, respectively (P = 0.73). The recurrence rate of ASBO was lower in the tube-splinting group (6.7%) than in the simple enterolysis group (40%) (P = 0.02).

Conclusion: Our findings indicate that tube splinting may be more useful than simple enterolysis alone in preventing the recurrence of ASBO in patients with SEP.

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Intraoperative photograph of a patient with SEP (membrane encapsulates the entire intestine).
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Fig1: Intraoperative photograph of a patient with SEP (membrane encapsulates the entire intestine).

Mentions: On laparotomy, 31 of the 44 patients were found to have membrane encapsulation extending throughout the entire intestine (Figure 1), while 13 had encapsulation of only small parts of the intestine. All patients had extensive adhesions between different bowel segments and between the membrane and intestine, with 12 patients exhibiting multiple matted inter-bowel adhesions. On laparotomy, all patients received total resection of membrane and lysis of adhesions. Six patients underwent inadvertent enterectomy. In all the patients, histologic examination of the membrane showed proliferation of fibrocytes and collagen fiber with nonspecific inflammatory reaction.Figure 1


Long intestinal tube splinting prevents postoperative adhesive small-bowel obstruction in sclerosing encapsulating peritonitis.

Li M, Zhu W, Li Y, Jiang J, Li J, Li N - BMC Gastroenterol (2014)

Intraoperative photograph of a patient with SEP (membrane encapsulates the entire intestine).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289301&req=5

Fig1: Intraoperative photograph of a patient with SEP (membrane encapsulates the entire intestine).
Mentions: On laparotomy, 31 of the 44 patients were found to have membrane encapsulation extending throughout the entire intestine (Figure 1), while 13 had encapsulation of only small parts of the intestine. All patients had extensive adhesions between different bowel segments and between the membrane and intestine, with 12 patients exhibiting multiple matted inter-bowel adhesions. On laparotomy, all patients received total resection of membrane and lysis of adhesions. Six patients underwent inadvertent enterectomy. In all the patients, histologic examination of the membrane showed proliferation of fibrocytes and collagen fiber with nonspecific inflammatory reaction.Figure 1

Bottom Line: The rate of complications was 9.1% and 6.1% in the simple enterolysis group and tube-splinting group, respectively (P = 0.73).The recurrence rate of ASBO was lower in the tube-splinting group (6.7%) than in the simple enterolysis group (40%) (P = 0.02).Our findings indicate that tube splinting may be more useful than simple enterolysis alone in preventing the recurrence of ASBO in patients with SEP.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Jinling Hospital, Medicine School of Nanjing University, NO 305 East Zhongshan Road, Nanjing, Jiangsu Province, China. liningrigs@vip.sina.com.

ABSTRACT

Background: Sclerosing encapsulating peritonitis (SEP) is a rare cause of small-bowel obstruction. The optimal treatment for this condition remains controversial.

Methods: In this study, we performed a retrospective analysis of the data of 44 patients who underwent surgery for SEP between December 2001 and 2008 at our hospital. The long-term follow-up data of the patients were assessed for the recurrence of adhesive small-bowel obstruction (ASBO), and patient survival was assessed to evaluate the efficiency of tube splinting in the prevention of postoperative ASBO.

Results: Of the 44 patients who underwent surgery for SEP, 33 underwent simple enterolysis along with tube splinting, while the remaining underwent only simple enterolysis. The median follow-up period was 79.4 ± 24.8 months (range: 8-123 months). The rate of complications was 9.1% and 6.1% in the simple enterolysis group and tube-splinting group, respectively (P = 0.73). The recurrence rate of ASBO was lower in the tube-splinting group (6.7%) than in the simple enterolysis group (40%) (P = 0.02).

Conclusion: Our findings indicate that tube splinting may be more useful than simple enterolysis alone in preventing the recurrence of ASBO in patients with SEP.

Show MeSH
Related in: MedlinePlus