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[Adhesive prophylaxis: Noble's intestine plication (author's transl)]
Langenbecks Archiv Fur Chirurgie
|November 1, 1978
Summary
Small intestine plication is effective for chronic adhesive ileus but contraindicated for acute conditions. Strict adherence to indications minimizes serious complications and achieves zero postoperative lethality.
Area of Science:
- Surgical Gastroenterology
- Abdominal Surgery
Context:
- Chronic adhesive small bowel obstruction presents significant clinical challenges.
- Surgical techniques like Noble or Childs-Philipps plication have been utilized for decades.
- Past approaches lacked strict adherence to indications, leading to poor outcomes.
Purpose:
- To evaluate the efficacy and safety of small intestine plication for chronic adhesive ileus.
- To define strict indications for small intestine plication to improve patient outcomes.
- To analyze the complication rates and lethality associated with small intestine plication.
Summary:
- Small intestine plication is a time-tested procedure for chronic, recurrent adhesive ileus.
- It is strongly contraindicated in acute ileus syndrome, peritonitis, and for prophylactic use due to high complication risks.
- A review of 233 cases at a university clinic demonstrated strict adherence to indications, resulting in no postoperative lethality.
Impact:
- Highlights the critical importance of patient selection for small intestine plication.
- Demonstrates that meticulous adherence to surgical indications can lead to excellent outcomes.
- Provides evidence supporting the continued use of plication in carefully selected chronic adhesive ileus cases.