Brief Article
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World J Gastroenterol. Apr 28, 2012; 18(16): 1968-1974
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1968
A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction
Xiao-Li Chen, Feng Ji, Qi Lin, Yi-Peng Chen, Jian-Jiang Lin, Feng Ye, Ji-Ren Yu, Yi-Jun Wu
Xiao-Li Chen, Feng Ji, Yi-Peng Chen, Ji-Ren Yu, Yi-Jun Wu, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Qi Lin, Department of Gastroenterology, Ningbo Branch Hospital of the First Affiliated Hospital, College of Medicine, Zhejiang University, Ningbo 315100, Zhejiang Province, China
Jian-Jiang Lin, Feng Ye, Department of Colon and Rectal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen XL and Ji F proposed the study, wrote the paper and analyzed the data; Ji F, Chen YP and Lin Q performed endoscopic placement of ileus tube and nasogastric tube; Lin JJ, Ye F, Yu JR and Wu YJ performed the surgeries; Ji F reviewed the article and gave the final approval; all authors contributed to the design and interpretation of the data.
Correspondence to: Feng Ji, MD, Professor of Medicine, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. jifeng1126@sina.com
Telephone: +86-571-87236861 Fax: +86-571-87235577
Received: July 29, 2011
Revised: November 8, 2011
Accepted: February 16, 2012
Published online: April 28, 2012
Abstract

AIM: To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.

METHODS: A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study. The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube (NGT) was used in 90 patients. The therapeutic efficacy was compared between the two groups.

RESULTS: Compared with the NGT group, the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph (4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests (P < 0.01). The overall effectiveness rate was up to 89.6% in the ileus tube group and 46.7% in the NGT group (P < 0.01). And 10.4% of the patients in the ileus tube group and 53.3% of the NGT group underwent surgery. For recurrent adhesive bowel obstruction, ileus tube was also significantly more effective than NGT (95.8% vs 31.6%). In the ileus tube group, the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure (P < 0.05). The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery.

CONCLUSION: Ileus tube can be used for adhesive small bowel obstruction. Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks.

Keywords: Adhesive, Small bowel obstruction, Ileus tube, Nasogastric intubation, Gastrointestinal decompression