Ahmad Maqbool, Abbas Safdar, Asghar Muhammad Imran
Department of Surgery, Combined Military Hospital, Pano Aqil Cantt.
J Coll Physicians Surg Pak. 2003 Nov;13(11):637-9.
To determine the outcome of colorectal surgery without mechanical bowel preparation.
A descriptive, analytical and observational study.
Combined Military Hospital, Kharian and Pano Aqil, from September 1998 to April 2003.
Forty-seven patients underwent debridement/resection and repair/primary anastomosis of colon and upper rectum without bowel preparation. Of these, 16 patients were operated in emergency. The anastomosis was carried out with polyglactin (vicryl) interrupted, full thickness single layer and no patient had defunctioning colostomy. Third generation cephalosporin, cefotaxime or ceftazidime and metronidazole were given perioperatively, repeated during surgery if lasted for more than 2 hours and continued for 3-5 days postoperatively.
Anastomoses were ileocolic in 29.7%, colicocolic in 61.7% and colorectal in 14.8% cases. Anastomotic failure was seen in 4.2% and wound infection in 8.5% cases. There was one mortality (2.1%) due to unrelated cause.
Mechanical bowel preparation is not necessary for safe colorectal surgery.
确定不进行机械性肠道准备的结直肠手术的结果。
一项描述性、分析性和观察性研究。
1998年9月至2003年4月在哈里亚恩和帕诺阿吉尔的联合军事医院。
47例患者在未进行肠道准备的情况下接受了结肠和直肠上段的清创/切除及修复/一期吻合术。其中，16例患者为急诊手术。吻合采用聚乙醇酸（薇乔）间断、全层单层缝合，无一例患者行造瘘术。围手术期给予第三代头孢菌素、头孢噻肟或头孢他啶及甲硝唑，手术持续时间超过2小时则术中重复给药，并在术后持续3 - 5天。
吻合方式为回结肠吻合的占29.7%，结肠结肠吻合的占61.7%，结直肠吻合的占14.8%。吻合口失败率为4.2%，伤口感染率为8.5%。有1例（2.1%）因无关原因死亡。
安全的结直肠手术无需进行机械性肠道准备。
