Clinical Research on Nonoperative Treatment for Incomplete Adhesive Small Bowel Obstruction after Laparotomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Ganlu , SHI Lizhi , HE De , LI Huijuan , LIU Meiqun , CHEN Hui , HUANG Bo.

Department of General Surgery, Shenzhen Baoan People’s Hospital, Shenzhen 518101, Guangdong Province, China;

Corresponding author：

Keywords：

Small bowel obstruction; Adhesive; Simethicone; Nonoperative treatment; Laparotomy

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ObjectiveTo study the application value of mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations in treatment for incomplete adhesive intestinal obstruction after laparotomy. MethodsOne hundred and twentyeight patients diagnosed incomplete adhesive intestinal obstruction admitted to this hospital from March 2005 to May 2008 were randomly divided into trial group and control group. For the control group, the tradition therapy including fasting, gastrointestinal decompression, fluid replacement therapy, and enema with soap and water were used for treatment. For the trial group, the mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations were injected into stomach by the nasogastric tube on the basis of traditional treatment used for the control group. Some indicators including the successful rate of nonoperative treatment, the time that obstructive symptoms resolved and returned to normal exhaust and defecation and normal diet, and recurrence rate were compared between two groups. ResultsThe successful rate of nonoperative treatmentin in the trial group were significantly higher than that in the control group 〔92.1% (70/76) versus 69.2% (36/52), P lt;0.01〕. The average time that recovered to normal exhaust and defecation in the trial group and the control group was 32.5 d and 47.8 d, respectively. The average time that recovered to normal diet in the trial group and the control group was 3.2 d and 5.3 d, respectively. The time that recovered to normal exhaust and defecation, and diet in the trial group were significantly shorter than those in the control group (P lt;0.01). The recurrence rate had no significant difference between two groups (P gt;0.05). ConclusionThe mixed formulations consisting of paraffin oil, dimethyl silicone oil, and senna preparations improve recovery of intestinal function and reduce surgical intervention rate.

Citation： WANG Ganlu,SHI Lizhi,HE De,LI Huijuan,LIU Meiqun,CHEN Hui,HUANG Bo.. Clinical Research on Nonoperative Treatment for Incomplete Adhesive Small Bowel Obstruction after Laparotomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(3): 286-289. doi: Copy

1.	Wilson MS, Hawkswell J, McCloy RF. Natural history of adhesional small bowel obstruction: counting the cost [J]. Br J Surg, 1998, 85(9): 12941298.
2.	Menzies D, Parker M, Hoare R, et al. Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions [J]. Ann R Coll Surg Engl, 2001, 83(1): 4046.
3.	Miller G, Boman J, Shrier I, et al. Natural history of patients with adhesive small bowel obstruction [J]. Br J Surg, 2000, 87(9): 12401247.
4.	胡孔旺, 朱化刚, 耿小平, 等. 粘连性肠梗阻手术指征多因素分析 [J]. 中国普外基础与临床杂志, 2010, 17(9): 939943.
5.	Ray NF, Larsen JW Jr, Stillman RJ, et al. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988 [J]. Surg Gynecol Obstet, 1993, 176(3): 271276.
6.	Seror D, Feigin E, Szold A, et al. How conservatively can postoperative small bowel obstruction be treated? [J]. Am J Surg, 1993, 165(1): 121125.
7.	Assalia A, Schein M, Kopelman D, et al. Therapeutic effect of oral gastrografin in adhesive, partial smallbowel obstruction: a prospective randomized trial [J]. Surgery, 1994, 115(4): 433437.
8.	Jeekel H. Cost implications of adhesions as highlighted in a European study [J]. Eur J Surg, 1997, 579(Suppl): 4345.
9.	张延龄. 腹膜粘连的形成及防治 [J]. 国外医学外科学分册, 1981, 1: 17.
10.	Cheynel N, Cortet M, Lepage C, et al. Trends in frequency and management of obstructing colorectal cancers in a welldefined population [J]. Dis Colon Rectum, 2007, 50(10): 15681575.
11.	章晓璟, 俞建平. 口服泛影葡胺联合中药治疗粘连性肠梗阻 [J]. 浙江临床医学, 2006, 8(7): 700.
12.	Chen SC, Lin FY, Lee PH, et al. Watersoluble contrast study predicts the need for early surgery in adhesive small bowel obstruction [J]. Br J Surg, 1998, 85(12): 16921694.
13.	Chen SC, Chang KJ, Lee PH, et al. Oral urografin in postoperative small bowel obstruction [J]. World J Surg, 1999, 23(10): 10511054.
14.	隋国德, 胡三元, 牛兆健, 等. 中西医结合治疗急性粘连性肠梗阻216例 [J]. 浙江中西医结合杂志, 2006, 16(5): 303304.
15.	黄宏汉, 孙淑明, 江树嵩. 肠粘连通畅汤临床应用研究 [J]. 医学通报, 2006, 5(2): 4244.
16.	史玉红. 粘连性不全性肠梗阻的综合治疗 [J]. 西部医学, 2006, 18(5): 626.
17.	钟德源, 欧志平, 管奇峰. 奥曲肽治疗粘连性肠梗阻疗效观察 [J]. 中华现代外科杂志, 2005, 2(10): 928929.
18.	姚宏伟, 傅卫, 袁炯, 等. 经鼻肠减压管在治疗急性粘连性小肠梗阻中的作用研究 [J]. 中华普通外科杂志, 2006, 21(10): 754755.
19.	潘雷. 149例粘连性肠梗阻诊治体会 [J]. 中国普外基础与临床杂志, 2002, 9(6): 434435.
20.	张毅, 侯勇, 侯昌映, 等. 泛影葡胺胃肠道造影在粘连性肠梗阻中的临床应用 [J]. 中国普外基础与临床杂志， 2006, 13(5): 595596.
21.	Tabibian JH. Management of highgrade smallbowel obstruction [J]. Arch Surg, 2010, 145(4): 404405.
22.	Chen SC, Lee CC, Yen ZS, et al. Specific oral medications decrease the need for surgery in adhesive partial smallbowel obstruction [J]. Surgery, 2006, 139(3): 312316.
23.	LengPeschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds [J]. J Pharm Pharmacol, 1986, 38(5): 369373.
24.	于世英, 王杰军, 王金万, 等. 晚期癌症患者合并肠梗阻治疗的专家共识 [J]. 中华肿瘤杂志, 2007, 29(8): 637640.

1. Wilson MS, Hawkswell J, McCloy RF. Natural history of adhesional small bowel obstruction: counting the cost [J]. Br J Surg, 1998, 85(9): 12941298.
2. Menzies D, Parker M, Hoare R, et al. Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions [J]. Ann R Coll Surg Engl, 2001, 83(1): 4046.
3. Miller G, Boman J, Shrier I, et al. Natural history of patients with adhesive small bowel obstruction [J]. Br J Surg, 2000, 87(9): 12401247.
4. 胡孔旺, 朱化刚, 耿小平, 等. 粘连性肠梗阻手术指征多因素分析 [J]. 中国普外基础与临床杂志, 2010, 17(9): 939943.
5. Ray NF, Larsen JW Jr, Stillman RJ, et al. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988 [J]. Surg Gynecol Obstet, 1993, 176(3): 271276.
6. Seror D, Feigin E, Szold A, et al. How conservatively can postoperative small bowel obstruction be treated? [J]. Am J Surg, 1993, 165(1): 121125.
7. Assalia A, Schein M, Kopelman D, et al. Therapeutic effect of oral gastrografin in adhesive, partial smallbowel obstruction: a prospective randomized trial [J]. Surgery, 1994, 115(4): 433437.
8. Jeekel H. Cost implications of adhesions as highlighted in a European study [J]. Eur J Surg, 1997, 579(Suppl): 4345.
9. 张延龄. 腹膜粘连的形成及防治 [J]. 国外医学外科学分册, 1981, 1: 17.
10. Cheynel N, Cortet M, Lepage C, et al. Trends in frequency and management of obstructing colorectal cancers in a welldefined population [J]. Dis Colon Rectum, 2007, 50(10): 15681575.
11. 章晓璟, 俞建平. 口服泛影葡胺联合中药治疗粘连性肠梗阻 [J]. 浙江临床医学, 2006, 8(7): 700.
12. Chen SC, Lin FY, Lee PH, et al. Watersoluble contrast study predicts the need for early surgery in adhesive small bowel obstruction [J]. Br J Surg, 1998, 85(12): 16921694.
13. Chen SC, Chang KJ, Lee PH, et al. Oral urografin in postoperative small bowel obstruction [J]. World J Surg, 1999, 23(10): 10511054.
14. 隋国德, 胡三元, 牛兆健, 等. 中西医结合治疗急性粘连性肠梗阻216例 [J]. 浙江中西医结合杂志, 2006, 16(5): 303304.
15. 黄宏汉, 孙淑明, 江树嵩. 肠粘连通畅汤临床应用研究 [J]. 医学通报, 2006, 5(2): 4244.
16. 史玉红. 粘连性不全性肠梗阻的综合治疗 [J]. 西部医学, 2006, 18(5): 626.
17. 钟德源, 欧志平, 管奇峰. 奥曲肽治疗粘连性肠梗阻疗效观察 [J]. 中华现代外科杂志, 2005, 2(10): 928929.
18. 姚宏伟, 傅卫, 袁炯, 等. 经鼻肠减压管在治疗急性粘连性小肠梗阻中的作用研究 [J]. 中华普通外科杂志, 2006, 21(10): 754755.
19. 潘雷. 149例粘连性肠梗阻诊治体会 [J]. 中国普外基础与临床杂志, 2002, 9(6): 434435.
20. 张毅, 侯勇, 侯昌映, 等. 泛影葡胺胃肠道造影在粘连性肠梗阻中的临床应用 [J]. 中国普外基础与临床杂志， 2006, 13(5): 595596.
21. Tabibian JH. Management of highgrade smallbowel obstruction [J]. Arch Surg, 2010, 145(4): 404405.
22. Chen SC, Lee CC, Yen ZS, et al. Specific oral medications decrease the need for surgery in adhesive partial smallbowel obstruction [J]. Surgery, 2006, 139(3): 312316.
23. LengPeschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds [J]. J Pharm Pharmacol, 1986, 38(5): 369373.
24. 于世英, 王杰军, 王金万, 等. 晚期癌症患者合并肠梗阻治疗的专家共识 [J]. 中华肿瘤杂志, 2007, 29(8): 637640.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Research on Nonoperative Treatment for Incomplete Adhesive Small Bowel Obstruction after Laparotomy

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