Long intestinal tube splinting prevents postoperative adhesive small-bowel obstruction in sclerosing encapsulating peritonitis

Abstract

BackgroundSclerosing encapsulating peritonitis (SEP) is a rare cause of small-bowel obstruction. The optimal treatment for this condition remains controversial.MethodsIn this study, we performed a retrospective analysis of the data of 44 patients who underwent surgery for SEP between December 2001 and 2008 at our hospital. The long-term follow-up data of the patients were assessed for the recurrence of adhesive small-bowel obstruction (ASBO), and patient survival was assessed to evaluate the efficiency of tube splinting in the prevention of postoperative ASBO.ResultsOf the 44 patients who underwent surgery for SEP, 33 underwent simple enterolysis along with tube splinting, while the remaining underwent only simple enterolysis. The median follow-up period was 79.4 ± 24.8 months (range: 8–123 months). The rate of complications was 9.1% and 6.1% in the simple enterolysis group and tube-splinting group, respectively (P = 0.73). The recurrence rate of ASBO was lower in the tube-splinting group (6.7%) than in the simple enterolysis group (40%) (P = 0.02).ConclusionOur findings indicate that tube splinting may be more useful than simple enterolysis alone in preventing the recurrence of ASBO in patients with SEP.

Sclerosing Encapsulating Peritonitis: Review

“…2,5,35 Several methods can be employed to reduce the incidence of postoperative intestinal obstruction, including intestinal intubation through the orifice of the appendix in patients with type II or III SEP, the use of steroids to reduce oedema, intestinal stasis or bacterial translocation and somatostatin administration to reduce secretion and intestinal distension. [1][2][3]45 Inserting long intestinal tube splinting may prevent a potential obstruction; thus, it would be wise to fix the bowel in a favourable position. 4 In one report, the postoperative complication rate among patients who underwent enterolysis alone was 9.1% compared to 6.1% among those with internal splinting; moreover, the recurrence rate of intestinal obstruction was significantly higher (40% versus 6.7%; P = 0.02).…”

A Diagnostic Dilemma for Acute Abdomen: Sclerosing Encapsulating Peritonitis (Abdominal Cocoon Syndrome); A Retrospective Cohort Study

“…In the long term, if resection has been performed, short bowel syndrome and associated anemia, vitamin deficiencies (B12) and fat absorption disorders may develop. 31 The most important limitation of our study is its retrospective nature. However, the number of cases for this pathology can be helpful for understanding the characteristics of this rare disorder.…”

Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction

“…Enterolysis is not adequate since adhesion and subsequent obstruction would probably occur. Intestinal plication is therefore suggested in addition to enterolysis for the management of abdominal cocoon [ 23 – 25 ]. Nevertheless, the majority of these studies were single-arm studies in the absence of control group, and none of these studies compared external versus internal plication.…”