A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction

Chen, Xiaoli; Ji, Feng; Lin, Qi; Chen, Yi-Peng; Lin, Jian-Jiang; Ye, Feng; Yu, Jiren; Wu, Yijun

doi:10.3748/wjg.v18.i16.1968

Cited by 49 publications

(53 citation statements)

References 19 publications

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“…Gastrointestinal decompression using an ileus tube or a nasogastric tube is considered to be an effective treatment in such patients [2]. A previous randomized controlled trial showed that the relief of clinical symptoms and improvement in the findings of abdominal radiography were quicker with an ileus tube than with a nasogastric tube [3]. Therefore, gastrointestinal decompression using an ileus tube is the first treatment choice in patients with ASBO at our hospital.…”

Section: Introductionmentioning

confidence: 97%

Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction

Tamura

Esaki

Ichijima

et al. 2020

Preprint

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Background: Gastrointestinal decompression through ileus tube is useful for the treatment of adhesive small bowel obstruction (ASBO). Gastrografin administration through the ileus tube is performed if decompression therapy fails to relieve obstruction. However, the efficacy and appropriate timing of gastrografin administration are unclear. This study aimed to evaluate the efficacy of gastrografin administration within 48 h after admission. Methods: This retrospective study used the data of patients with ASBO admitted to our hospital between January 2014 and August 2018 and included those who underwent ileus tube intubation but did not achieve obstruction relief for over 24 h after admission. The patients were classified into the following two groups: those treated with gastrografin administration within 48 h after admission (EGA group) and those treated without gastrografin administration within 48 h after admission (non-EGA [NEGA] group). Propensity-score matching was performed to compensate for confounding differences between the groups. The short-term outcomes including the rate of successful conservative management without surgery, the period until the first stool, the period of ileus tube intubation, the total period of hospital admission, and adverse events due to gastrografin administration were evaluated and compared between the two groups. Results: This study included 152 patients: 67 in the EGA group and 85 in the NEGA group. Fifty-five pairs were matched with similar background characteristics. After matching, the rates of successful conservative management were 89.1% (49/55) and 94.5% (52/55) in the matched EGA and NEGA groups, respectively (P=0.49). Although the median insertion days of ileus tube in the NEGA group were significantly lesser than those in the EGA group (7 [5–9] vs. 5 [4.5–7], P=0.017), other therapeutic outcomes did not differ significantly. In the NEGA group, 5.5% (3/55) achieved obstruction relief without gastrografin administration. Aspiration pneumonia occurred in one patients of EGA group. Conclusions: Gastrografin administration with ileus tube achieved a high rate of successful conservative management. Follow-up by decompression with ileus tube for at least 48 h after admission is required in patients with ASBO, which may avoid unnecessary gastrografin administration and consequently reduce the total cost of treatment.

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Section: Introductionmentioning

confidence: 97%

Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction

Tamura

Esaki

Ichijima

et al. 2020

Preprint

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“…In addition, there have been reports from many countries describing the usefulness of LT decompression for the management of SBO. [1–4,6–8] Therefore, if the clinical course after NGT insertion is not satisfactory, we have to consider inserting the LT instead.…”

Section: Introductionmentioning

confidence: 99%

A new method for insertion of long intestinal tube for small bowel obstruction

Sekiba

Ohmae²,

Odawara³

et al. 2016

Medicine

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It is often difficult to insert a long intestinal tube (LT) in patients with small bowel obstruction (SBO). We developed a novel technique for inserting an LT without endoscopy called nonendoscopic over-the-wire method via short nasogastric tube (NEWSt). We evaluated the efficacy and safety of NEWSt.We performed a retrospective study of patients who underwent LT insertion for SBO without any indications of strangulation with either NEWSt (n = 16) or endoscopy (n = 17) between November 2011 and February 2015 at our hospital. Univariate analysis was used to assess the success rate of LT placement beyond the duodenojejunal flexure, time required for the procedure, clinical outcomes, and adverse events.The success rate was 100% in both groups. Procedure time was numerically, but not statistically, shorter in the NEWSt group compared with the endoscopy group (24 ± 13 vs 30 ± 13 min; P = 0.174). There were no statistically significant differences between the 2 groups in terms of surgery rate (31% vs 12%; P = 0.225), fasting period (11.3 ± 6.3 vs 9.9 ± 4.5 days; P = 0.482), hospital stay (26.4 ± 22.1 vs 18.7 ± 7.0 days; P = 0.194), and recurrence rate (19% vs 24%; P = 1.0). No serious adverse event was observed in the NEWSt group, whereas serious aspiration pneumonia was observed in 2 patients after LT insertion in the endoscopy group.Without endoscopy, NEWSt enabled the high success rate and the short procedure time for the LT insertion. Prospective, randomized controlled trials are needed.

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“…Small bowel obstruction (SBO) is usually caused by postoperative adhesions that develop in about 95% of adult patients after abdominal surgery . Some recent studies have shown that long transnasal tube decompression achieves favorable outcomes . We herein report a new effective transnasal ileus tube insertion method called the anterior balloon method to achieve decompression for adhesive SBO …”

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confidence: 99%

Effective insertion method of transnasal ileus tube for adhesive small bowel obstruction

Yamaguchi

Morisaki

Tsunada

2017

Digestive Endoscopy

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A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction

Abstract: 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.

Cited by 49 publications

References 19 publications

Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction

Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction

A new method for insertion of long intestinal tube for small bowel obstruction

Effective insertion method of transnasal ileus tube for adhesive small bowel obstruction

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