Twelve-year experience with the long intestinal tube

Abstract

A number of surgical methods, including use of the long intestinal tube, have been designed to decrease the incidence of recurrent small bowel obstruction. The aim of the present study was to review the indications, morbidity, and long-term results of the long intestinal tube at the Mayo Clinic. During the 12-year period 1981-1992, 47 patients had such tubes placed. The patients formed a complex surgical group: 46 patients had previously undergone at least one laparotomy (median 4, range 1-10); 41 patients had been hospitalized at least once for small bowel obstruction (median 3, range 1-15); and all 41 of these patients had undergone at least one previous laparotomy for obstruction (median 2, range 1-7). Eleven patients had a history of inflammatory bowel disease, and eight had a history of irradiation. In addition to dense adhesions in 46 patients, operative findings included large bowel tumors in six patients, intraperitoneal carcinomatosis in four, intraabdominal abscess in four, and small bowel stricture in three. Twenty patients required either a small bowel or large bowel resection, and three had a stoma fashioned. Only one case of morbidity (tube retraction) was related to tube placement. Among the 36 patients with complete follow-up, nine patients developed episodes of recurrent adhesional small bowel obstruction after a mean follow-up of 48 months, although only one required laparotomy. Of the remaining 11 patients it is known that two developed small bowel obstruction, one of whom required laparotomy.(ABSTRACT TRUNCATED AT 250 WORDS)