Twelve-year experience with the Thow long intestinal tube: A means of preventing postoperative bowel obstruction

The purpose of this study was to determine the effectiveness of the Thew lo ng intestinal tube (LIT) for prevention of postoperative adhesive small bow el obstruction (ASBO) and to compare the Thew tube with other LITs. The cha rts of all patients who had placement of a Thew tube between January 1986 a cid November 1998 were reviewed. Thirty-four patients ranging in age from 9 to 86 years (mean 57.9) were included in the study. Twenty-five were conta cted by phone for long-term follow-up. Twenty-nine patients had undergone p revious abdominal surgery, and in 11 of 29 the previous surgery was for ASB O, Indications for surgery and Thew tube placement included: bowel obstruct ion (25), perforated viscus (five), carcinomatosis (two), colitis tone), an d atonic bowel tone). Review of the operative notes revealed no difficulty in advancing the Thew tube in 32 of 34 patients (94%). Thew tube-related co mplications occurred in nine patients (25%). All complications were associa ted with the gastrostomy site, and only one patient required surgery for th e complication. Two (5.9%) patients developed recurrent obstruction during a mean follow-up of 52 months. In one patient the obstruction was caused by adhesions and in another it was the result of an intra-abdominal abscess. Of 23 patients treated for ASBO at the time of Thew tube placement no patie nt (0%) developed recurrent ASBO during the follow-up period (total 110.5 p atient-years). This study along with a review of the literature suggests th at LITs decrease the risk of recurrent ASBO. The Thew tube, however, is eas ily placed and is associated with fewer and less severe complications than other LITs.