Intraluminal Miller-Abbott tube stenting as treatment and prophylaxis of recurrent intestinal obstruction

Abstract

Chronic recurrent intestinal obstruction due to massive adhesions after abdominal surgery is a complication that is difficult to treat. The records were studied of 25 patients with acute intestinal obstruction due to massive adhesions. Since conservative measurements were unsuccessful, the patients were treated with internal intestinal splinting by means of a Miller-Abbott tube. These 25 patients underwent a total of 72 operations, 36 were performed for mechanical obstruction. Conservative treatment alone was effective during 25 admissions. The complaints of the patients lasted five years on an average. After lysis of adhesions the Miller-Abbott tube was introduced either via the nose, via a gastrostomy or via an enterostomy. The tube was left in situ for three weeks and then gradually withdrawn. There was no hospital mortality. There was one postoperative complication: a tube had to be removed under general anaesthesia. Long-term follow-up of the patients varied from 4.5 to 19 years with a mean of 11.3 years. One patient with recurrent intestinal obstruction due to adhesions, required surgical intervention after one year. A second patient with Peutz-Jeghers syndrome needed surgery because of an intestinal adenoma after six years. The mean symptom-free interval was 11.1 years in the cured patients.