Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
Tech Coloproctol. 2020 Sep;24(9):943-946. doi: 10.1007/s10151-020-02244-3. Epub 2020 Jun 6.
Performing a tension-free anastomosis following extensive left-sided colorectal resection can be challenging due to limited length. The retro-ileal pull-through approach, where the colon is carefully delivered to the pelvis through a mesenteric window made under the ileocolic vessels, is a technique to perform such an anastomosis.
This series is a retrospective review of patients who underwent a colorectal or coloanal anastomosis using the retro-ileal pull-through approach. Patient demographics, operative reports, and short-term outcomes were reviewed.
Seven patients had a retro-ileal pull-through technique with colorectal or coloanal anastomosis. The cohort included 3 patients who had a Hartman's reversal, 3 who had a redo colorectal anastomosis and one in whom this technique was used in an acute setting for sigmoid colectomy for acute perforated diverticulitis with primary anastomosis. Successful implementation of the technique was achieved in all patients with good short-term outcomes.
In our cohort of patients, a retro-ileal pull-through technique was shown to be a successful approach to achieve a tension-free colorectal or coloanal anastomosis in various scenarios. This technique may prevent performing an ileorectal anastomosis or a permanent colostomy. We believe that this approach should be popularized among colorectal surgeons dealing with complicated colorectal operations.
由于左侧结直肠切除范围广泛，导致长度有限，进行无张力吻合可能具有挑战性。回肠后拖出术是一种将结肠通过回结肠血管下方的系膜窗小心送达骨盆的技术，可用于完成此类吻合。
本系列是对接受回肠后拖出术进行结直肠或结肠直肠吻合的患者进行的回顾性研究。回顾了患者的人口统计学资料、手术报告和短期结果。
7 名患者接受了回肠后拖出术行结直肠或结肠直肠吻合。该队列包括 3 例 Hartman 复位术、3 例重新进行的结直肠吻合术，以及 1 例在急性情况下用于因急性穿孔性憩室炎而行的乙状结肠切除术的一期吻合术。所有患者均成功实施了该技术，且短期结果良好。
在我们的患者队列中，回肠后拖出术是一种成功的方法，可在各种情况下实现无张力结直肠或结肠直肠吻合。该技术可以避免进行回肠直肠吻合术或永久性结肠造口术。我们认为，这种方法应该在处理复杂结直肠手术的结直肠外科医生中得到推广。
