McKay Andrew, Bathe Oliver F
Department of Surgery, University of Calgary, Calgary, AB, Canada.
J Gastrointest Surg. 2007 Oct;11(10):1365-7. doi: 10.1007/s11605-007-0230-z. Epub 2007 Jul 17.
A competent ileocecal valve complicates the surgical treatment of an unresectable obstructing mid-colon tumor. Specifically, it may not be feasible to bypass with a colocolotomy, especially when the sigmoid colon has limited mobility or if the ascending colon is severely distended and edematous. A technique is described in which the closed loop obstruction is relieved at its proximal extent by an ileocecal valvuloplasty. A circular stapling device is fired across the ileocecal valve. Once the ileocecal valve is rendered competent, a loop ileostomy or a colocolotomy can be constructed, providing effective palliation for this difficult situation.
功能正常的回盲瓣会使不可切除的结肠中段梗阻性肿瘤的手术治疗变得复杂。具体而言，通过结肠结肠吻合术进行旁路手术可能不可行，尤其是当乙状结肠活动度有限或升结肠严重扩张和水肿时。本文描述了一种技术，即通过回盲瓣成形术在近端解除闭环梗阻。使用环形吻合器穿过回盲瓣击发。一旦回盲瓣功能恢复正常，就可以进行袢式回肠造口术或结肠结肠吻合术，为这种困难情况提供有效的姑息治疗。
