Grasso Marica, Cimmino Alessandro, Sangiuliano Nicola, Niglio Antonello
Faculty of Medicine and Surgery, University of Salerno, Via S. Allende, 84080 Baronissi, Salerno, Italy.
UOC Chirurgia Generale 2, AORN Cardarelli, Naples, Italy.
Int J Surg Case Rep. 2018;47:64-66. doi: 10.1016/j.ijscr.2018.04.015. Epub 2018 Apr 21.
Nowadays, after wide left colectomy, it is necessary to choose one of the following procedures: a definitive transverse colostomy, an ileo-rectal anastomosis or a right colo-rectal anastomosis (Deloyers procedure).
We performed our new procedure on a 63 years-old man. After an extensive left proctocolectomy, the intestinal continuity between the transverse colon and rectum was obtained by transposition and rotation of the right colon into the pelvis. After recanalization the patient never lost the functions of the large intestine and progressively restored continence.
Saving the transverse colon and the right colon mean achieving not only continence but also a better degree of reabsorption of liquids and vitamin K and group B production in order to keep intestinal functions as similar as possible to the normal physiology.
The one-year follow-up surgical and clinical outcomes are encouraging to support the feasibility of this procedure in terms of improving the quality of life: avoiding diarrhea, incontinence and post-operative urgency.
如今，在广泛的左半结肠切除术后，有必要选择以下手术之一：确定性横结肠造口术、回肠直肠吻合术或右半结肠直肠吻合术（德洛耶尔手术）。
我们对一名63岁男性实施了我们的新手术。在进行广泛的直肠结肠切除术之后，通过将右半结肠移位并旋转至盆腔，实现了横结肠与直肠之间的肠道连续性。再通后，患者从未丧失大肠功能，并逐渐恢复了控便能力。
保留横结肠和右半结肠不仅意味着实现控便，还意味着在液体再吸收以及维生素K和B族维生素生成方面达到更好的程度，从而使肠道功能尽可能接近正常生理状态。
一年的随访手术和临床结果令人鼓舞，支持了该手术在改善生活质量方面的可行性：避免腹泻、失禁和术后尿急。
