{"title":"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。","authors":"Er-Sheng Li, Yin-Jun Zhai, Yin Han, Qian Chang, Qi Wang, Hong-Yu Zhang","doi":"10.3389/fsurg.2025.1601111","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1601111"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477208/pdf/","citationCount":"0","resultStr":"{\"title\":\"A novel approach of manual manipulation of the transnasal ileus tube for severe or recurrent benign adhesive small bowel obstruction.\",\"authors\":\"Er-Sheng Li, Yin-Jun Zhai, Yin Han, Qian Chang, Qi Wang, Hong-Yu Zhang\",\"doi\":\"10.3389/fsurg.2025.1601111\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"12 \",\"pages\":\"1601111\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477208/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2025.1601111\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1601111","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
A novel approach of manual manipulation of the transnasal ileus tube for severe or recurrent benign adhesive small bowel obstruction.
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.
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.
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