Polese L, Lezoche E, Porzionato A, Lezoche G, Da Dalt G, Macchi V, Stecco C, De Caro R, Norberto L, Merigliano S
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
Colorectal Dis. 2014 Oct;16(10):O367-9. doi: 10.1111/codi.12684.
An ileorectal bypass performed entirely through a transanal route has recently been described in an animal model. The present study aimed to demonstrate its technical feasibility in four human cadavers.
A transanal endoscopic microsurgery (TEM) device and endoscopic instruments were used. The principal steps of the procedure included insertion of the TEM device, rectostomy above the peritoneal reflection, peritoneoscopy using a standard gastroscope and delivery of the small bowel through the proctostomy to perform an anastomosis.
The procedure was successfully completed using transanal access in all cases. The mean procedure time was 90 min. The bypass was patent, and the anastomosis between the intraperitoneal rectum and the terminal ileum was leakproof.
Transanal ileoproctostomy is technically feasible in human cadavers. The procedure may become an alternative to stoma formation in selected patients with colonic obstruction.
最近在动物模型中描述了一种完全经肛门途径进行的回直肠旁路手术。本研究旨在在四具人体尸体中证明其技术可行性。
使用经肛门内镜显微手术（TEM）设备和内镜器械。该手术的主要步骤包括插入TEM设备、在腹膜反折上方进行直肠造口、使用标准胃镜进行腹腔镜检查以及通过直肠造口将小肠引出以进行吻合。
所有病例均通过经肛门途径成功完成手术。平均手术时间为90分钟。旁路通畅，腹膜内直肠与回肠末端之间的吻合无渗漏。
经肛门回直肠造口术在人体尸体中技术上是可行的。该手术可能成为某些结肠梗阻患者造口形成的替代方法。
