Complications and results of 160 Baker tube plications. | Semantic Scholar (2024)

Use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients.

Splinting of the entire small bowel by intraoperative passage of a long tube, which is left indwelling for 2–3 weeks, appears to be effective and safe and has been followed by freedom from recurrence during 103 patient-years of follow-up.

Intraluminal stenting remains of unproven efficacy and may find a place as an adjunct to adhesolysis in patients requiring repeated operations for the relief of obstruction due to extensive and dense adhesions; but, in view of the high rate of complications, careful case selection will be necessary.

Patients in four neighboring district general hospitals in the United Kingdom who required a total of 236 admissions over a 12-month prospective period were reviewed, and adhesions accounted for 75 admissions, malignant disease for 61, strangulated hernias for 59, and volvulus for 10, while other causes were all in single figures.

It is shown that endoscopically placed long intestinal tubes have the capability to decompress a distended bowel and break through the pathophysiologic cascade of ileus and can be used for intraluminal stenting after adhesiolysis to prevent recurrent obstruction.

Operative treatment is indicated to relieve obstructions that fail to resolve with conservative measures, and involves lysis of adhesions or resections.

Splinting was a reasonably safe procedure with comparatively low morbidity and mortality, reduced the rate of late recurrent SBO in patients treated for late adhesive SBO as compared with historical outcome data of simple enterolysis and prevented late SBO when performed prophylactically.

The Thow tube, however, is easily placed and is associated with fewer and less severe complications than other LITs.

...

...

For most patients, the cecostomy approach, if performed with great care, will prove to be safe, convenient, and effective.

The frequency and precise causes of post-operative mechanical obstruction in a consecutive series of 1302 cases treated by combined excision at St. Mark's Hospital from January, 1936, to December, 1949 are analysed.

Enterolysis alone as the treatment for bowel obstruction as a result of adhesions appears to be as good or better than the long tube stent.

The records of 238 putients with the diagnosis of small bowel obstruction at the University of Illinois Hospital from 1967 through the spring of 1976 were reviewed and revealed a 60% incidence of wound infection in patients in whom an enterotomy was made and the subcutaneous tissue and skin closed, and it is therefore recommended that the wound be left open in these situations.

Clinical material is drawn from a nonuniversity hospital of 375 beds and 75 bassinets during the period of 1945 to 1951, during which there were 98,590 hospital admissions, of which 43,490 were hospital admissions.

It is suggested that as a result of the experience at St Mark's Hospital some of the points of clinical interest and importance in relation to familial adenomatosis coli are reviewed, and present knowledge of other forms of gastrointestinal polyposis and their associated disorders are reviewed.

...

...