Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2023; 15(9): 1950-1958
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1950
Efficacy of ileus tube combined with meglumine diatrizoate in treating postoperative inflammatory bowel obstruction after surgery
Wen Yang, Jing Pu
Wen Yang, Jing Pu, Department of Third General Surgery, Lanzhou Second People’s Hospital, Lanzhou 730046, Gansu Province, China
Author contributions: Yang W initiated the project, designed the experiment, performed postoperative follow-up and recorded data, and wrote the original manuscript; Pu J conducted collated data, assisted with the statistical analysis, and revised the paper; all authors reviewed and approved the paper; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Lanzhou Second People’s Hospital.
Informed consent statement: Due to the retrospective design, patient consent was not required.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Pu, MD, Doctor, Department of Third General Surgery, Lanzhou Second People’s Hospital, No. 388 Jingyuan Road, Lanzhou 730046, Gansu Province, China. 18119373828@163.com
Received: May 21, 2023
Peer-review started: May 21, 2023
First decision: June 1, 2023
Revised: July 3, 2023
Accepted: July 29, 2023
Article in press: July 29, 2023
Published online: September 27, 2023
Processing time: 124 Days and 10.5 Hours
Abstract
BACKGROUND

Early postoperative inflammatory small bowel obstruction (EPISBO) is easy to be complicated after colorectal cancer surgery. Both intestinal obstruction catheter and meglumine can treat EPISBO.

AIM

To investigate the efficacy of an intestinal obstruction tube combined with meglumine diazo in treating EPISBO of colorectal cancer.

METHODS

Data from 60 patients with colorectal cancer and intestinal obstruction admitted to the Proctology Department of our hospital from April 2018 to May 2022 were collected and analyzed and divided into three cohorts according to different treatment regimens. Cohort A (n = 20) received a transnasal intestinal obstruction catheter with panumglumine, and cohort B (n = 20) received a transnasal intestinal obstruction catheter with liquid paraffin. Cohort C (n = 20) received oral treatment with meglumine. The clinical efficacy, first exhaust/defecation time, length of hospital stay, gastrointestinal decompression time, relief time of abdominal pain, and relief time of abdominal distension were compared among the three cohorts. The levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), serum albumin, and transferrin were compared among the three cohorts before and after treatment. The occurrence of adverse reactions in the three cohorts was compared.

RESULTS

Compared with cohort C, the successful treatment rate of cohort A was significantly higher. There were statistically significant variations in the time of first exhaust/defecation, length of hospital stays, gastrointestinal decompression time, relief time of abdominal pain, and relief time of abdominal distention among the three cohorts. Compared with cohort C, cohort A’s first exhaust/defecation time, hospitalization time, gastrointestinal decompression time, abdominal pain relief time, and abdominal distension relief time was reduced (P < 0.05). After treatment, serum CRP, TNF-α, IL-6, and MCP-1 expression levels increased, and serum albumin and serum transferrin levels increased in the three cohorts. The serum albumin level in cohort A was higher than in cohort C. Compared with cohort B and cohort C, the serum transferrin level in cohort A increased (P < 0.05). Compared with cohort C, the total incidence of adverse reactions in cohorts A and B was significantly higher (P < 0.05). The incidence of adverse reactions was similar between cohort A and cohort B.

CONCLUSION

Using an ileus tube combined with meglumine diatrizoate can effectively treat postoperative inflammatory ileus obstructions after surgery colorectal cancer and improve prognosis, inflammatory response, and nutritional status.

Keywords: Ileus tube; Meglumine diatrizoate; Colorectal cancer; Inflammatory bowel obstruction; Early postoperative inflammatory small bowel obstruction

Core Tip: Early postoperative inflammatory small bowel obstruction (EPISBO) patients with colorectal cancer that were difficult to re-operate were mostly treated with conservative therapy. Transnasal ileus catheter has better hypotensive effect and has been widely used in the treatment of EPISBO. However, the effect of combined ileus catheter and meglumine in the treatment of EPISBO has not been discussed in detail. The objective of this study was to compare the efficacy of oral meglumine for EPISBO, ileus catheter alone and ileus catheter combined with meglumine for EPISBO. The effect of intestinal obstruction catheter combined with meglumine in the treatment of EPISBO is better than that of treatment alone.