Backer surgery

Backer surgery is a procedure in which the small intestine is aligned. It is used to prevent re-adhesion obstruction after separation of intestinal obstruction. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: adhesive intestinal obstruction and intestinal obstruction Indication A wide range of cases with adhesions. Contraindications No relevant information. Preoperative preparation 1. The vast majority of patients come to the clinic with pain, vomiting, swelling, and other conditions. It is advisable to first perform gastrointestinal decompression to correct the imbalance of water and electrolyte balance. If the general condition is poor or there is anemia, a small amount of blood transfusion should be performed. If possible, it is best to wait until the general condition is restored before performing elective surgery. However, if the obstruction is not relieved, you should actively prepare for the early surgery, do not hesitate, when you miss the surgery. 2. Oral erythromycin or streptomycin, metronidazole to reduce intestinal bacteria. 3. Due to the long operation time, there is more bleeding, and the blood should be 400-800ml before operation. 4. Place the stomach tube. 5. If tuberculous peritonitis or intestinal tuberculosis caused by intestinal adhesions, anti-tuberculosis drugs should be used before surgery, until the tuberculosis lesions are relatively stable before surgery. Surgical procedure In 1959 Backer reported a seamless line of alignment surgery - internal stenting. The principle is to place a plastic or rubber catheter in the lumen of the small intestine. The stent is used to maintain the curvature of all the intestines in an obtuse angle. Even if it is stuck again, it does not form an acute angle and obstruction. This method was proposed for White in 1956, but it was promoted by Backer. A common method is to insert a MA tube from the stump after removal of the appendix or directly in the outer cecum of the cecum after separating all the adhesions, and then inflate the balloon after entering the small intestine. The air bag is placed after pushing it proximally into the duodenum. Arrange the small intestines as neatly as possible, avoid bending into acute angles, and then poke the MA tube in the right lower abdomen. The MA tube can also be inserted through the nose, stomach or through the upper ostium of the jejunum, and inserted into the ascending colon from top to bottom. The advantage of the enterostomy is to avoid long-term indwelling of the tube through the nasopharynx. The disadvantage is that an extra-intestinal stoma is made, and some complications after stoma may occur. complication The internal stent does not require suture, and the operation is simple and time-saving, safe and effective. However, there are certain failure rates and complications, such as persistent gastric or intestinal paralysis, difficulty in extubation, convulsions in the jejunum or cecum, and persistent abdominal cramps. However, very few intestinal obstructions recur. Weigelt reported 160 cases in 1980, with an average follow-up of 3.9 years after surgery. The complications caused by the tube were 7% and the recurrence of obstruction was 9%.