Long term follow-up of the use of the Jones tube in adhesive small bowel obstruction.

Aims: Intestinal intubation with a Jones tube has been suggested as a way to reduce the incidence of recurrent adhesive small bowel obstruction by allowing the subsequent adhesions to form in a favorable position. This paper aims to assess the success and long term outcome of this technique using a retrospective study. Methods: A case-note review was performed on all the patients who were identified as having the Jones intestinal tube placed over an eleven year period from 1980 to 1991, with a follow up to 2001, yielding a total of 56 patients. The indication for placement and outcome following placement of the tube were documented with particular reference to recurrence of adhesive obstruction. Results: Data on 46 patients were available, with a median follow up of 92 months representing 353 patient years: 34 patients had the tube placed during emergency surgery for division of adhesions; 12 patients had the tube placed on an elective basis of which 7 had the Jones tube placed as prophylaxis against adhesive obstruction during formation of a Parks pouch, the remaining 5 having the tube placed for recurrent small bowel obstruction. Four patients in total had recurrent small bowel obstruction; two of these had intervening surgery not related to adhesive obstruction. Conclusion: Intestinal intubation with a Jones tube is a safe and effective method of preventing recurrent adhesive obstruction. It is also effective prophylactically where the initial surgery is likely to result in multiple adhesions. [ABSTRACT FROM AUTHOR]