Paşalega M, Meşină C, Calotă F, Vâlcea D, Nemes R, Burdescu C, Curcă T, Paraliov T, Mirea C, Tenea T, Vasile I
Clinica chirurgie II, U.M.F. Craiova.
Chirurgia (Bucur). 2004 Nov-Dec;99(6):515-21.
To evaluate the problems of approach, of technique and of care as a 20 years experience demonstrates.
a retrospective study including 45 operated cases where the large-bowel served as reconstructive material (in 33 cases the transverse colon and in 12 cases right ileocolon).
Healing was obtained in 42 patients. Early postoperative evolution presented: peritonitis caused by anastomotic leakages--2 cases, hemoperitoneum--2 cases, cervical fistula --1 case, wound infection--6 cases, evisceration--1 case, acute respiratory failure--6 cases. Cervical anastomosis reconstruction for late stenosis--1 case. There were 2 postoperative deaths by haemorrhagic shock and peritonitis--mortality 4.4.
Reconstruction by using the large-bowel was justified through anatomic argumentation (sufficient vascular supply), technic argumentation (easy anastomosis, tension free, short time of execution), functional argumentation (good compliance of large-bowel to the new function).
Coloesophagoplasty is an efficient method on the condition of a strict planning: continent gastrostomy and evolvement of vascular arcades due to previous vascular "carving".
随着20年的经验积累，评估手术入路、技术及护理方面的问题。
一项回顾性研究，纳入45例使用大肠作为重建材料的手术病例（33例使用横结肠，12例使用右半结肠回肠）。
42例患者愈合。术后早期出现：吻合口漏导致的腹膜炎2例、腹腔积血2例、颈部瘘1例、伤口感染6例、脏器脱出1例、急性呼吸衰竭6例。晚期狭窄行颈部吻合口重建1例。术后因失血性休克和腹膜炎死亡2例，死亡率4.4%。
通过解剖学论证（血供充足）、技术论证（吻合容易、无张力、操作时间短）、功能论证（大肠对新功能顺应性良好），证明使用大肠进行重建是合理的。
在严格规划的情况下，结肠食管成形术是一种有效的方法：即建立可控性胃造口术以及因先前血管“裁剪”而形成的血管弓的演变。
