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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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Cumulative survival rates after surgery in patients who did or did not undergo tube splinting (Kaplan–Meier analysis).
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Fig3: Cumulative survival rates after surgery in patients who did or did not undergo tube splinting (Kaplan–Meier analysis).

Mentions: Six patients (15%) had 17 episodes of postoperative ASBO: 15 were managed conservatively and 2, surgically (Table 1). One patient required 1 hospital admission for postoperative ASBO, 1 required 2 admissions, 3 required 3, and 1 required 5. The cumulative incidence of ASBO was 10% at 1 year, 12.5% at 2 years, and 15% at 3 years and at the end of study. The number of postoperative ASBO episodes was greater in the simple enterolysis group (4/10; 40%) than in the tube splinting group (2/30; 6.7%) [P = 0.02; HR = 0.134 (0.024–0.773)] (Figure 3).Figure 3


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)

Cumulative survival rates after surgery in patients who did or did not undergo tube splinting (Kaplan–Meier analysis).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Cumulative survival rates after surgery in patients who did or did not undergo tube splinting (Kaplan–Meier analysis).
Mentions: Six patients (15%) had 17 episodes of postoperative ASBO: 15 were managed conservatively and 2, surgically (Table 1). One patient required 1 hospital admission for postoperative ASBO, 1 required 2 admissions, 3 required 3, and 1 required 5. The cumulative incidence of ASBO was 10% at 1 year, 12.5% at 2 years, and 15% at 3 years and at the end of study. The number of postoperative ASBO episodes was greater in the simple enterolysis group (4/10; 40%) than in the tube splinting group (2/30; 6.7%) [P = 0.02; HR = 0.134 (0.024–0.773)] (Figure 3).Figure 3

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