[实验性局限性粪性腹膜炎中一期结肠吻合术与结肠造口术的比较]
[Comparison of primary colonic anastomosis and colostomy in experimental localized fecal peritonitis].
作者信息
Kayaalp Cüneyt, Balkan Müjdat, Aydin Cenk, Oner Köksal
机构信息
Gülhane Askeri Tip Akademisi, Genel Cerrahi Anabilim Dali, Ankara.
出版信息
Ulus Travma Acil Cerrahi Derg. 2003 Jul;9(3):160-2.
BACKGROUND
To investigate the appropriate surgical method that should be selected in the localized fecal peritonitis due to colonic injuries with 24 hours delay.
METHODS
Colonic injuries were performed in 35 rats and the repairs were carried out after 24 hours. Seven rats (%20) died of generalized peritonitis in this period. The remaining 28 rats in which fecal peritonitis were localized by surrounding organs, were randomized in two groups: colostomy (n=14) and primary anastomosis (n=14). Intraabdominal complications and 15 days mortality were assessed.
RESULTS
The groups had similar results according to intraabdominal complications. The 15 days survival was 71.4 % for the colostomy group and 78.5 % for the anastomosis group (p=0.31)
CONCLUSION
If the injured or perforated colon is surrounded by the organs and so the generalized peritonitis is avoided, primary anastomosis would have similar results with colostomy despite fecal contamination and prolonged intervention time.
背景
探讨因结肠损伤延迟24小时导致局限性粪性腹膜炎时应选择的合适手术方法。
方法
对35只大鼠造成结肠损伤，24小时后进行修复。在此期间，7只大鼠（20%）死于弥漫性腹膜炎。其余28只因周围器官局限了粪性腹膜炎的大鼠被随机分为两组：结肠造口术组（n = 14）和一期吻合术组（n = 14）。评估腹腔内并发症和15天死亡率。
结果
根据腹腔内并发症情况，两组结果相似。结肠造口术组15天生存率为71.4%，吻合术组为78.5%（p = 0.31）。
结论
如果受损或穿孔的结肠被周围器官包裹，从而避免了弥漫性腹膜炎，尽管存在粪便污染和手术时间延长的情况，一期吻合术与结肠造口术的结果相似。
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