PubMedDate not supplied
The state of the art with regard to surgical management in the prevention and treatment of intestinal occlusion caused by adhesions is described and the various operations proposed are examined. Noble's operation (folding and overcast suture of the intestinal loops)-the first to be proposed requires too much time for its execution. In addition, it restricts loop mobility and thus predisposes to recurrences and complications. The operation of Childs & Philips (folding of the intestine by accordion attachment of the mesentery with transfixing, looped wires) is quicker, but its wires result in a certain degree of vascular and enteric affection. Folding via intubation of the whole of the small intestine with a long catheter, using a nasogastric, gastrostomic or jejunostomic route, is both simple and rapid. It is particularly advisable in non-peritonitic obstruction in children and as a prophylactic measure. Reymond's operation (enteropexy with two simple and fundamental, lateral "virage" sutures) may be segmentary or total, or confined to a few loops. It is very simple and quick. It can always be used and is adaptable to the objective situation in each case. Personal experience with this operation in 69 cases (54 "therapeutic" and 15 "prophylactic") is presented. Two instances of recurrence due to poor technique were noted. It is felt that the operation is extremely satisfactory.