{Reference Type}: Journal Article
{Title}: Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction.
{Author}: Liu S;Hu Q;Shao L;Lu X;Shen X;Ai S;Zeng P;Wang M;Guan W;
{Journal}: BMC Surg
{Volume}: 21
{Issue}: 1
{Year}: Jul 2021 12
{Factor}: 2.03
{DOI}: 10.1186/s12893-021-01304-1
{Abstract}: <B>BACKGROUND: </B>Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO.<BR><B>METHODS: </B>All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well.<BR><B>RESULTS: </B>Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery.<BR><B>CONCLUSIONS: </B>This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.