A novel approach of manual manipulation of the transnasal ileus tube for severe or recurrent benign adhesive small bowel obstruction.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1601111

Er-Sheng Li, Yin-Jun Zhai, Yin Han, Qian Chang, Qi Wang, Hong-Yu Zhang

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引用次数: 0

Abstract

Purpose: This study seeks to evaluate the safety and efficacy of an innovative manual manipulation technique for the transnasal ileus tube in patients experiencing severe or recurrent adhesive small bowel obstruction (ASBO).

Materials and methods: Prior to the initiation of this research, approval was obtained from the institutional review board. The study was conducted within our institution, involving a cohort of fifty-four patients diagnosed with severe, multiple, or recurrent ASBO. These patients underwent treatment through active manipulation of the transnasal ileus tube, which entailed navigating obstructions by adjusting two balloons and resolving adhesions through the alternate advancement and retraction of the ileus tube. Angiographic outcomes were categorized as either complete or incomplete resolution of obstructions. Data were collected on technical success, initial and final angiographic outcomes, mortality, morbidity, and overall clinical outcomes. Follow-up assessments were conducted at 1, 3, 6, and 12 months, with annual evaluations thereafter.

Results: The transnasal ileus tube was successfully placed in all patients without any procedure-related complications. The tube was successfully navigated and passed through obstructions to the cecum in 94.4% of cases, specifically in 51 out of 54 attempts. Follow-up angiograms, conducted over a period of 3-38 months, confirmed the unobstructed passage of contrast medium through the small bowel in 52 patients. Clinical follow-up data, with an average duration of 20 ± 11 months (95% CI: 17, 23 months; range, 6-45 months), were available for 52 patients. One patient died due to multiple organ failure, while the remaining 51 patients exhibited no clinical symptoms of small bowel obstruction.

Conclusion: These preliminary findings indicate that manual manipulation of the transnasal ileus tube is non-surgical and therefore non-traumatic but nonetheless an effective method of internally lysing the adhesions with their double balloon technique and pulling the tube back and forth.

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手工操作经鼻肠梗阻管治疗严重或复发性良性粘连小肠梗阻的新方法。

目的：本研究旨在评估一种创新的手动操作技术用于重度或复发性粘连性小肠梗阻（ASBO）患者经鼻肠梗阻管的安全性和有效性。材料和方法：在本研究开始之前，已获得机构审查委员会的批准。该研究是在我们的机构内进行的，涉及54名被诊断为严重、多发性或复发性ASBO的患者。这些患者通过主动操作经鼻肠梗阻管进行治疗，这需要通过调整两个气球来导航阻塞，并通过交替进退肠梗阻管来解决粘连。血管造影结果分为完全或不完全解决阻塞。收集技术成功、初始和最终血管造影结果、死亡率、发病率和总体临床结果的数据。随访评估分别在1、3、6和12个月进行，此后每年进行一次评估。结果：所有患者均成功置入经鼻肠梗阻管，无手术相关并发症。在94.4%的病例中，54次尝试中有51次成功通过盲肠。随访血管造影3-38个月，证实52例患者造影剂通过小肠通畅。52例患者的临床随访资料平均持续时间为20±11个月（95% CI: 17, 23个月；范围6-45个月）。1例患者死于多器官功能衰竭，其余51例患者无小肠梗阻临床症状。结论：这些初步结果表明，手动操作经鼻肠梗阻管是非手术性的，因此是非创伤性的，但仍然是一种有效的方法，通过双球囊技术和前后拉管来内部溶解粘连。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.