Conzo G, Stanzione F, Celsi S, Palazzo A, Della Pietra C, Candilio G, Livrea A
2nd University of Naples,Italy.
G Chir. 2010 Nov-Dec;31(11-12):487-90.
Mechanical cecorectal anastomosis after subtotal colectomy, in the treatment of slow transit constipation, probably represents the most attractive surgical alternative to total colectomy and ileorectal anastomosis. In fact the operation allows better results in terms of postoperative diarrhoea, fecal incontinence and postoperative adherential syndrome. Literature data have demonstrated the feasibility of the laparoscopic approach with tipically advantages of less invasive surgery respect of parietal integrity,less postoperative pain and ileus, fewer postoperative adhesions, a reduced hospitalitation and finally, a better cosmesis. The Authors report a case of mechanical end to end cecorectal anastomosis after laparo-assisted subtotal colectomy (by four trocars) preserving superior rectal and ilecolic vessels, for the treatment of slow transit constipation in a 20 years old male patient .The reported operative approach which links tipical laparoscopic advantages to a more "safety" and "accurate" extracorporeal mechanical anastomosis.
在治疗慢传输型便秘时,次全结肠切除术后行机械性盲直肠吻合术,可能是全结肠切除及回直肠吻合术最具吸引力的手术替代方案。事实上,该手术在术后腹泻、大便失禁及术后粘连综合征方面能取得更好的效果。文献数据已证实腹腔镜手术方法的可行性,其具有典型的优势,如相对于腹壁完整性而言侵袭性较小、术后疼痛及肠梗阻较轻、术后粘连较少、住院时间缩短,最后还有更好的美容效果。作者报告了一例20岁男性患者,因慢传输型便秘在腹腔镜辅助次全结肠切除术后(通过四个套管针)行机械性端端盲直肠吻合术,保留直肠上血管和回结肠血管。所报道的手术方法将典型的腹腔镜优势与更“安全”和“精确”的体外机械吻合相结合。