Gervin A S, Hoffman M J, Fischer R P
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Am J Surg. 1987 Dec;154(6):648-50. doi: 10.1016/0002-9610(87)90235-2.
Primary anastomosis can often be safely performed between the distal ileum and colon after emergent right colectomy. However, when this is not possible, we believe that this ileocolostomy procedure can be performed safely and offers an attractive alternative to ileostomy. It differs from the classic Paul-Mikulicz procedure in that a common channel is created at the initial operation using a stapling device. This obviates the inherent risks of blindly placing bulky spur clamps between the colon and ileum in the postoperative period. Using this technique, we have encountered no staple line leaks, fluid or electrolyte imbalance, or skin excoriation in the postoperative or follow-up period of 26 patients. All ileocolostomies were closed through the ileocolostomy site without formal laparotomy and without complications.
急诊右半结肠切除术后，回肠末端与结肠之间通常可安全地进行一期吻合。然而，若无法进行一期吻合，我们认为这种回结肠造口术可安全实施，是回肠造口术的一个有吸引力的替代方案。它与经典的保罗 - 米库利奇手术不同，在于初次手术时使用吻合器创建一个共同通道。这避免了术后在结肠和回肠之间盲目放置大型钉夹的固有风险。采用这种技术，我们在26例患者的术后及随访期未遇到吻合口漏、液体或电解质失衡或皮肤擦伤的情况。所有回结肠造口均通过回结肠造口部位关闭，无需进行正规剖腹手术，且无并发症发生。
