Effectiveness of intestinal tube splinting: A prospective observational study

Background/Aims: To assess the effectiveness of intestinal tube splinting. Patients and Methods: The clinical, operative and outcome data of 186 patie nts undergoing 200 intestinal splinting procedures from 1973 until 1996 wer e accumulated in a prospective database. Endpoints were perioperative morbi dity, mortality and the incidence of subsequent small bowel obstruction (SB O). The latest follow-up performed in 1998 updated the outcome of 197 proce dures after 1-25 (median 7) years. Results: In the early postoperative peri od, the overall incidence of complications was 9%, procedural complications 2%, and repeat surgery 3%. Three patients died during the index hospitaliz ation. No patient suffered early SBO, Between 1 and 13 years after splintin g, 6 complete SBOs (3%) necessitated reoperation and 5 incomplete SBOs (2.5 %) were managed conservatively. After splinting for late SBO, freedom from complete SBO was 0.989 and of incomplete SBO 0.906, after splinting for ear ly SBO 0.872 and 0.972, respectively, and for segmental peritonitic SBO fre edom from complete SBO 0.8. No obstruction followed prophylactic splinting. Conclusions: Splinting was a reasonably safe procedure with comparatively low morbidity and mortality. The procedure prevented early SBO in all indic atory subgroups, reduced the rate of late recurrent SBO in patients treated for late adhesive SBO as compared with historical outcome data of simple e nterolysis and prevented late SBO when performed prophylactically. Copyrigh t (C) 2000 S. Karger AG, Basel.