Nishijima E, Kimura K, Maeda K, Nakamura K
Department of Surgery, Kobe University School of Medicine.
Kobe J Med Sci. 1991 Feb;37(1):1-12.
A colonic patch graft technique which consists of a three-staged procedure, was developed in order to diminish ileostomy complications and to reconstruct rectoanal function in patients with extensive aganglionosis. The basic data on creation of the colonic patch graft remains uncertain.
Using 20 experimental dogs, a colonic patch graft was created by forming a longitudinal side-to-side ileocolostomy, followed in 10 weeks by severance of the colonic mesentery which feeds the anastomosed colon segment. Five weeks after division of the primary blood supply, histological studies of the walls of the colonic graft were carried out in 10 dogs. Effect of severance of the colonic mesentery on water and electrolytes absorption through the ileocolostomy segment was evaluated by single perfusion method in 10 dogs.
The significant abnormality noted was marked thickening of the submucosal layer secondary to persistent lymphstasis. Other layers of the bowel wall were not abnormal including the mucosa, muscle layers, and intramural ganglion cells. The severance of the colonic mesentery belonging to the ileocolostomy segment did not affect its absorptive capacity for water and electrolytes.
The histological findings support the observation that absorptive function in the mucosa of the colonic patch graft is not significantly disturbed, although lymphstasis is observed in the submucosa.
为减少回肠造口术并发症并重建广泛神经节缺失患者的直肠肛管功能，研发了一种分三步进行的结肠补片移植技术。关于结肠补片移植构建的基础数据仍不明确。
使用20只实验犬，通过形成纵行侧侧回结肠造口术构建结肠补片移植，10周后切断为吻合的结肠段供血的结肠系膜。在切断主要血供5周后，对10只犬的结肠移植物壁进行组织学研究。通过单灌流法评估10只犬结肠系膜切断对回结肠造口段水和电解质吸收的影响。
观察到的显著异常是由于持续性淋巴淤滞导致黏膜下层明显增厚。肠壁的其他层包括黏膜、肌层和壁内神经节细胞均无异常。属于回结肠造口段的结肠系膜切断不影响其对水和电解质的吸收能力。
组织学研究结果支持以下观察结果，即尽管在黏膜下层观察到淋巴淤滞，但结肠补片移植黏膜的吸收功能未受到明显干扰。
