
FOLLOWUS
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
网络出版日期:2015-06-20,
纸质出版日期:2015-06
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Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance[J]. 中国医学科学杂志(英文版), 2015,30(3):156-161.
Wang Zhi-wei, Li Xiao-guang, Pan Jie, et al. Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance[J]. Chinese medical sciences journal, 2015, 30(3): 156-161.
Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance[J]. 中国医学科学杂志(英文版), 2015,30(3):156-161. DOI:
Wang Zhi-wei, Li Xiao-guang, Pan Jie, et al. Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance[J]. Chinese medical sciences journal, 2015, 30(3): 156-161. DOI:
Objective
To investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).
Methods
Fifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time
the radiation exposure time
and the incidence of complications were evaluated.
Results
The long tubes passed into the jejunum on initial insertion for all patients
so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4±8.6 minutes
and the mean radiation exposure time 18.9±6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.
Conclusions
Using the wire-exchange technique
it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.
Sajja SBS , Schein M. Early small bowel obstruction. Brit J Surg 2004 ; 91 : 683 - 91 .
Volpe CM. Early postoperative small bowel obstruction. South Med J 2007 ; 100 : 975 .
Nakajima J , Sasaki A , Otsuka K , et al. Risk factors for early postoperative small bowel obstruction after colectomy for colorectal cancer. World J Surg 2010 ; 34 : 1086 - 90 .
Stewart RM , Page CP , Brender J. The incidence and risk of early postoperative small bowel obstruction: a cohort study. Am J Surg 1987 ; 154 : 643 - 7 .
Seror D , Feigin E , Szold A , et al. How conservatively can postoperative small bowel obstruction be treated? Am J Surg 1993 ; 165 : 121 - 6 .
Williams SB , Greenspon J , Young HA , et al. Small bowel obstruction: conservative vs. Surgical management. Dis Colon Rectum 2005 ; 48 : 1140 - 6 .
Jeong WK , Lim SB , Choi HS , et al. Conservative manage- ment of adhesive small bowel obstructions in patients previously operated on for primary colorectal cancer. J Gastrointest Surg 2008 ; 12 : 926 - 32 .
Guo SB , Duan ZJ. Decompression of the small bowel by endoscopic long-tube placement. World J Gastroenterol 2012 ; 18 : 1822 - 6 .
Gowen GF. Long tube decompression is successful in 90% of patients with adhesive small bowel obstruction. Am J Surg 2003 ; 185 : 512 - 5 .
Gowen GF. Rapid resolution of small-bowel obstruction with the long tube, endoscopically advanced into the jejunum. Am J Surg 2007 ; 193 : 184 - 9 .
Pickleman J , Lee RM. The management of patients with suspected early postoperative small-bowel obstruction. Ann Surg 1989 ; 210 : 216 - 9 .
Ellis H , Moran BJ , Thompson JN , et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery. Lancet 1999 ; 353 : 1476 - 80 .
Huynh T , Mercer D. Early postoperative small bowel obstruction caused by spilled gall stones during laparo- scopic cholecystectomy. Surgery 1996 ; 119 : 352 - 3 .
Tanaka S , Yamamoto T , Kubota D , et al. Predictive factors for surgical indication in adhesive small bowel obstruction. Am J Surg 2008 ; 196 : 23 - 7 .
Kanno Y , Hirasawa D , Fujita N , et al. Long-tube insertion with the ropeway method facilitated by a guidewire placed by transnasal ultrathin endoscopy for bowel obstruction: a prospective, randomized, controlled trial. Gastrointest Endosc 2009 ; 69 : 1363 - 8 .
Sato R , Watari J , Tanabe H , et al. Transnasal ultrathin endoscopy for placement of a long intestinal tube in patients with intestinal obstruction. Gastrointest Endosc 2008 ; 67 : 953 - 7 .
Ishizuka M , Nagata H , Takagi K , et al. Transnasal fine gastrointestinal fiberscope-guided long tube insertion for patients with small bowel obstruction. J Gastrointest Surg 2009 ; 13 : 550 - 4 .
Fleshner PR , Siegman MG , Slater GI , et al. A prospective, randomized trial of short versus long tubes in adhesive small-bowel obstruction. Am J Surg 1995 ; 170 : 366 - 70 .
Maglinte DD , Kelvin FM , Rowe MG , et al. Small-bowel obstruction: optimizing radiologic investigation and nonsurgical management. Radiology 2001 ; 218 : 39 - 46 .
Brandt LJ. Patients' attitudes and apprehensions about endoscopy: how to calm troubled waters . Am J Gastro- enterol 2001 ; 96 : 280 - 4 .
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