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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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Long intestinal tube introduced through the base of the appendix after appendicectomy.
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Fig2: Long intestinal tube introduced through the base of the appendix after appendicectomy.

Mentions: The decision of whether tube splinting should be performed for the patients was made on the basis of the attending surgeon’s opinion of whether tube splinting was effective in preventing the recurrence of ASBO. Therefore, some patients (n = 33) underwent tube splinting, while others did not. Two, three, or four 16-F tubes of length 150 cm were used as necessary and sutured together using 2/0 silk. Small side holes were cut at 15-cm intervals along the tubes. Appendicectomy was performed, and the tube was introduced into the base of the appendix (n = 26) or the stump of the terminal ileal anastomosis (n = 1) and then advanced upwards into the duodenojejunal flexure (Figure 2). In the remaining 6 patients who had previously undergone appendectomy, the tubes were introduced via cecostomy. The tubes were left in situ for a median duration of 11.5 ± 2.4 days, after which the tubes were removed.Figure 2


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)

Long intestinal tube introduced through the base of the appendix after appendicectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Long intestinal tube introduced through the base of the appendix after appendicectomy.
Mentions: The decision of whether tube splinting should be performed for the patients was made on the basis of the attending surgeon’s opinion of whether tube splinting was effective in preventing the recurrence of ASBO. Therefore, some patients (n = 33) underwent tube splinting, while others did not. Two, three, or four 16-F tubes of length 150 cm were used as necessary and sutured together using 2/0 silk. Small side holes were cut at 15-cm intervals along the tubes. Appendicectomy was performed, and the tube was introduced into the base of the appendix (n = 26) or the stump of the terminal ileal anastomosis (n = 1) and then advanced upwards into the duodenojejunal flexure (Figure 2). In the remaining 6 patients who had previously undergone appendectomy, the tubes were introduced via cecostomy. The tubes were left in situ for a median duration of 11.5 ± 2.4 days, after which the tubes were removed.Figure 2

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