Long Tubes vs Nasogastric Tubes in the Treatment of Intestinal Obstruction

To the Editor.—The article by Wolfson and associates¹ in the Archives presents a favorably biased opinion regarding the efficacy of long-tube decompression in the treatment of adhesive intestinal obstruction. Unfortunately, some of their conclusions are not consistently supported by data in the article.

The authors appropriately make the distinction between partial and complete intestinal obstruction but subsequently fail to acknowledge the fact that nearly two thirds of the patients with complete obstruction did not respond to tube decompression and required operation. The authors also state that passage of a long tube beyond the pylorus was of "significant predictive value with respect to the success of nonoperative therapy." This statement does not hold up for the 33 patients with complete obstruction. A χ² analysis using the data in Table 3 shows no significant difference in the number of patients with complete obstruction who required operation regardless of whether