title: Conservative treatment of early postoperative small bowel obstruction with obliterative peritonitis.
abstract: OBJECTIVE
  To investigate the effect of somatostatin and dexamethasone on early postoperative small bowel obstruction with obliterative peritonitis (EPSBO-OP).
  
  
  METHODS
  This prospective randomized study included 70 patients diagnosed with EPSBO-OP from June 2002 to January 2009. Patients were randomized into two groups: a control group received total parenteral nutrition and nasogastric (NG) tube feeding; and an intervention group received, in addition, somatostatin and dexamethasone treatment. The primary endpoints were time to resolution of bowel obstruction and length of hospital stay, and the secondary endpoints were daily NG output and NG feeding duration, treatment-related complications, postoperative obstruction relapse, and patient satisfaction.
  
  
  RESULTS
  Thirty-six patients were allocated to the intervention group and 34 to the control group. No patient needed to undergo surgery. Patients in the intervention group had an earlier resolution of bowel obstruction (22.4 ± 9.1 vs 29.9 ± 10.1 d, P = 0.002). Lower daily NG output (583 ± 208 vs 922 ± 399 mL/d, P < 0.001), shorter duration of NG tube use (16.7 ± 8.8 vs 27.7 ± 9.9 d, P < 0.001), and shorter length of hospital stay (25.8 vs 34.9 d, P = 0.001) were observed in the intervention group. The rate of treatment-related complications (P = 0.770) and relapse of obstruction (P = 0.357) were comparable between the two groups. There were no significant differences in postoperative satisfaction at 1, 2 and 3 years between the two groups.
  
  
  CONCLUSIONS
  Somatostatin and dexamethasone for EPSBO-OP promote resolution of obstruction and shorten hospital stay, and are safe for symptom control without increasing obstruction relapse.
authors.affiliation: Jian-Feng Gong, Wei-Ming Zhu, Wen-Kui Yu, Ning Li, Jie-Shou Li, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Gong
authors.affiliation: Jian-Feng Gong, Wei-Ming Zhu, Wen-Kui Yu, Ning Li, Jie-Shou Li, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Zhu
authors.affiliation: Jian-Feng Gong, Wei-Ming Zhu, Wen-Kui Yu, Ning Li, Jie-Shou Li, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Wen-Kui
authors.initials: WK
authors.lastname: Yu
authors.affiliation: Jian-Feng Gong, Wei-Ming Zhu, Wen-Kui Yu, Ning Li, Jie-Shou Li, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: Jian-Feng Gong, Wei-Ming Zhu, Wen-Kui Yu, Ning Li, Jie-Shou Li, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007441:Intubation, Gastrointestinal; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D017060:Patient Satisfaction; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D013004:Somatostatin / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D013004:Somatostatin; D003907:Dexamethasone
keywords: Dexamethasone; Intestinal obstruction; Parenteral nutrition; Postoperative period; Somatostatin