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重新审视桑图利造口术:成人适应证

Santulli enterostomy revisited: indications in adults.

作者信息

Anadol A Ziya, Topgül Koray

机构信息

Department of Surgery, Ondokuz Mayis University, School of Medicine, Atakent, 55200, Samsun, Turkey.

出版信息

World J Surg. 2006 Oct;30(10):1935-8. doi: 10.1007/s00268-005-0690-9.

Abstract

BACKGROUND

Surgical patients frequently need some type of intestinal stomas for a wide spectrum of disorders. Maintaining effective and enough decompression of gastrointestinal tract, securing distal bowel segments and anastomosis are the primary goals of ostomy formation as well as providing a minimum complication rate of closure or "take-down".

METHOD

In this report, we present five adult patients who were operated for some kind of intestinal disease and required enterostomy. We preferred Santulli type of enterostomy which was formerly used by pediatric surgeons. In this technique, the proximal afferent bowel is fashioned into a stoma and anastomosed side-to-end with double layer sutures into the distal efferent bowel.

RESULT

One of the five patients died of systemic problems, other four did well in terms of surgical outcome of the stoma.

CONCLUSION

We concluded that; although indications are limited, Santulli enterostomy can be performed in adult patients as effective as pediatric age group, particularly for its advantages in early restoration of intestinal continuity and diminished risk for post-closure complications.

摘要

背景

外科手术患者因多种疾病常常需要某种类型的肠造口。维持胃肠道有效且充分的减压、确保远端肠段及吻合口安全是造口形成的主要目标,同时要使关闭或“回纳”的并发症发生率降至最低。

方法

在本报告中,我们介绍了5例因某种肠道疾病接受手术且需要肠造口的成年患者。我们选用了小儿外科医生以前使用的桑图利(Santulli)式肠造口术。在该技术中,近端传入肠管被做成造口,并通过双层缝合与远端传出肠管端侧吻合。

结果

5例患者中有1例死于全身性问题,其他4例造口手术结果良好。

结论

我们得出结论:尽管适应证有限,但桑图利肠造口术在成年患者中实施时与儿童年龄组一样有效,特别是因其在早期恢复肠道连续性以及降低关闭后并发症风险方面的优势。

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