Fukami Yasuyuki, Terasaki Masaki, Sakaguchi Kenji, Murata Toru, Ohkubo Masayuki, Nishimae Kazumi
Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Shizuoka, 422-8527, Japan.
Surg Today. 2009;39(3):265-8. doi: 10.1007/s00595-008-3817-4. Epub 2009 Mar 12.
This report describes the use of side-to-end anastomosis in a colostomy for an acute malignant large-bowel obstruction. A 59-year-old man presented with a colonic obstruction due to advanced descending colon cancer. The preoperative imaging studies revealed a complete obstruction of the descending colon at the site of the splenic flexure, a remarkably dilated transverse colon, and no other metastatic lesions. Side-to-end anastomosis was performed with the colostomy because of the high comorbidity associated with such cases. When the patient's general condition improved, a stoma closure was performed under local anesthesia. In conclusion, a side-to-end anastomosis with a colostomy (STEC procedure) was found to be a simple, useful, and cost-effective technique for an acute malignant large-bowel obstruction, particularly in a high-risk patient.
本报告描述了端侧吻合术在急性恶性大肠梗阻结肠造口术中的应用。一名59岁男性因降结肠癌晚期出现结肠梗阻。术前影像学检查显示,降结肠在脾曲处完全梗阻,横结肠明显扩张,且无其他转移病灶。由于此类病例合并症发生率高,故行结肠造口术时采用端侧吻合术。待患者一般情况改善后,在局部麻醉下进行造口关闭。总之,端侧吻合结肠造口术(STEC手术)被认为是一种治疗急性恶性大肠梗阻的简单、实用且经济有效的技术,尤其适用于高危患者。