Document Detail


Intestinal splinting for uncomplicated early postoperative small bowel obstruction: is it worthwhile?
MedLine Citation:
PMID:  8884295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Established indications (obstructing extensive fibrous adhesions) and contraindications (solitary band- and short segment midgut adhesive obstruction, purulence) of intestinal tube splinting have emerged from clinical practice. The benefit of tube splinting for early postoperative small bowel obstruction (SBO), however, is still a matter of debate. METHODS: From Jan 1980 until Dec. 1989, all patients undergoing relaparotomy for uncomplicated early postoperative SBO were randomized for enterolysis, gut decompression and repair (group A, 28 patients) or the same procedure plus tube splinting (group B, 28 patients). The patients were comparable with respect to gender, age and type of preceding operations; they were followed for 5-14 years or until death. RESULTS: In the early postoperative period, 3 incidences of reobstruction and 8 of other complications were observed in group A vs. 0 and 2, respectively, in group B. No patient died. During follow-up, one patient suffered late SBO, 2 patients recurrent partial SBO and one patient died of bowel perforation in group A vs two incidences of late SBO in group B. CONCLUSIONS: Intestinal splinting performed for early postoperative SBO rendered a significant reduction of early postoperative complications; the protective efficacy against early reobstruction was clinically apparent but reached borderline significance only. In respect to late intestinal complications, splinting was not superior to simple enterolysis. Early and late complications taken together and intestinal complications considered separately were significantly more frequent in patients without splinting.
Authors:
K Meissner
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  43     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    1996 Jul-Aug
Date Detail:
Created Date:  1997-01-27     Completed Date:  1997-01-27     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  GREECE    
Other Details:
Languages:  eng     Pagination:  813-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, District General Hospital, Tamsweg, Austria.
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MeSH Terms
Descriptor/Qualifier:
Decompression, Surgical
Female
Follow-Up Studies
Humans
Intestinal Obstruction / epidemiology,  therapy*
Intestine, Small
Intubation, Gastrointestinal*
Male
Middle Aged
Postoperative Complications / epidemiology,  therapy*
Reoperation
Stents*
Time Factors
Tissue Adhesions / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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