Cady J, Godfroy J, Sibaud O
Clinique Geoffroy Saint-Hilaire, Paris.
Ann Chir. 1991;45(10):896-900.
Fifty-eight cases of peritonitis due to perforated sigmoid diverticulitis observed over a period of 10 years were treated by emergency mechanical resection-anastomosis without any post-operative anastomotic complication with a mortality in 2 cases (4%). An early operation with large resection and suture as far as possible from the initial focus give results similar to those of a regular anastomosis. The degree of peritoneal affect and especially the general state of health can impose limits to colectomy in the emergency situation. In the light of the results obtained, the use of the circular stapler with the triple stapling technique is now recommended without any particular protection of the suture.
在10年期间观察到58例乙状结肠憩室炎穿孔所致腹膜炎患者,均接受了急诊机械性切除吻合术,术后无吻合口并发症,2例(4%)死亡。早期手术,进行大范围切除并尽可能远离初始病灶缝合,其结果与常规吻合术相似。腹膜受累程度,尤其是患者的总体健康状况,可能会在紧急情况下限制结肠切除术的实施。根据所获得的结果,现推荐使用圆形吻合器及三重吻合技术,无需对吻合口进行特殊保护。