Post S, Schuster K L
Chirurgische Klinik, Klinikum Mannheim, Universität Heidelberg.
Chirurg. 2000 May;71(5):524-31. doi: 10.1007/s001040050850.
Because of the marked heterogeneity of patient groups and the diverse causes of obstruction, surgical therapy of the small-bowel ileus is difficult to standardize. A homogeneous strategy of intraoperative handling of the obstructed bowel (decompression, endoluminal splinting) as well as abdominal closure would be desirable. Adhesiolysis remains the most common procedure. Small bowel plication is still used by a minority of surgeons with the Noble's technique replaced by the Child-Phillips' technique and its modifications. However, as a result of the lack of controlled studies, there is no large body of evidence available to support the use of plication, long tubes or any other specific surgical intervention. This is an important task for the future, especially in view of incidence and economic importance of small bowel-ileus.
由于患者群体存在显著异质性以及梗阻原因多种多样，小肠肠梗阻的外科治疗难以标准化。对于梗阻肠管的术中处理（减压、腔内支撑）以及腹部闭合，采用统一的策略会是理想的。粘连松解术仍然是最常见的手术。少数外科医生仍在使用小肠折叠术，诺布尔技术已被蔡尔德 - 菲利普斯技术及其改良方法所取代。然而，由于缺乏对照研究，尚无大量证据支持使用折叠术、长管或任何其他特定的外科干预措施。鉴于小肠肠梗阻的发病率和经济重要性，这是未来一项重要任务。
