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吻合器修复完全性结直肠吻合口梗阻

Stapled revision of complete colorectal anastomotic obstruction.

作者信息

McKee Rohini, Pricolo Victor E

机构信息

Division of Colorectal Surgery, Department of Surgery, Brown University, Providence, RI, USA.

出版信息

Am J Surg. 2008 Apr;195(4):526-7. doi: 10.1016/j.amjsurg.2007.02.030.

Abstract

Colonic and rectal anastomotic strictures occur with an incidence ranging from 3% to 30%. Several factors, such as defunctionalization, anastomotic leak, ischemia, radiation, and neoplasms, have been implicated in their pathogenesis. Management of large bowel strictures is generally based on their cause, location, and appearance. Various methods have been described, including endoscopic techniques (eg, balloon dilatation and/or stents) and operative revision. Postoperative rectal strictures usually respond well to direct dilatation, without the need for endoscopic balloons. If surgical revision is necessary, morbidity can be significant, as in any reoperative procedure. We hereby present a novel surgical method of revision for a complete anastomotic obstruction, which proved effective and avoided extensive operative dissection, mobilization, and re-resection.

摘要

结肠和直肠吻合口狭窄的发生率在3%至30%之间。多种因素,如去功能化、吻合口漏、缺血、放疗和肿瘤,与它们的发病机制有关。大肠狭窄的处理通常基于其病因、位置和外观。已描述了多种方法,包括内镜技术(如球囊扩张和/或支架置入)和手术修复。术后直肠狭窄通常对直接扩张反应良好,无需内镜球囊。如果需要手术修复,与任何再次手术一样,发病率可能会很高。我们在此介绍一种用于完全吻合口梗阻的新型手术修复方法,该方法已证明有效,且避免了广泛的手术解剖、游离和再次切除。

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