Gramegna A, Saccomani G, Foscolo P P, Secondo P, Amato A, Durante V
Dipartimento di Gastroenterologia e Chirurgia Ospedale Civile, Sanremo, Italia.
Ann Chir. 1997;51(9):981-5.
In a retrospective series of 95 patients requiring emergency surgery for distal colonic obstruction, primary bowel resection followed by immediate anastomosis after intraoperative colonic irrigation was performed. Carcinoma was the cause of obstruction in 81 cases (85%); 13 patients had diverticulitis, and 1 had sigmoid volvulus. The technique of on-table lavage was similar to that described by Dudley in 1980: a caecostomy tube was used in 86 patients (90%) and was removed on the tenth postoperative day. 4 patients died, none from complications of anastomotic leakage. There were three anastomotic leakages (3.1%) and 10 radiologic leaks were observed. 3 patients were reoperated. The mean hospital stay was 23 days. The results of this study suggest that intraoperative colonic irrigation is an effective method, enabling the surgeon to perform primary anastomosis with reasonable safety after emergency resection of selected distal colonic lesions.
在一项针对95例因结肠远端梗阻而需要急诊手术的患者的回顾性研究中，采取了术中结肠灌洗后行一期肠切除并立即吻合的手术方式。81例（85%）患者梗阻的原因是癌；13例患者患有憩室炎，1例患有乙状结肠扭转。台上灌洗技术与1980年达德利所描述的技术相似：86例（90%）患者使用了盲肠造瘘管，术后第10天拔除。4例患者死亡，均非吻合口漏并发症所致。发生了3例吻合口漏（3.1%），观察到10例影像学上的渗漏。3例患者接受了再次手术。平均住院时间为23天。本研究结果表明，术中结肠灌洗是一种有效的方法，使外科医生能够在急诊切除选定的结肠远端病变后以合理的安全性进行一期吻合。
