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右半结肠切除术联合完整结肠系膜切除术治疗癌症,基于肠系膜的回肠结肠切除术治疗克罗恩病时使用聚合物结扎夹关闭肠系膜。

Mesenteric closure with polymer-ligating clips after right colectomy with complete mesocolic excision for cancer and mesentery-based ileocolic resection for Crohn's disease.

机构信息

Department of Surgery, University of Rome "Tor Vergata", Rome, Italy.

出版信息

Tech Coloproctol. 2021 Sep;25(9):1079-1084. doi: 10.1007/s10151-021-02493-w. Epub 2021 Jul 15.

Abstract

Mesenteric closure following right colectomy remains controversial and, following the advent of laparoscopic surgery, many surgeons do not routinely close the mesentery after colorectal resection. Nevertheless, especially after the introduction of operations such as right colectomy with complete mesocolic excision and ileocolic resections with extensive mesentery removal for Crohn's disease, the wide mesenteric defect resulting from the dissections can certainly expose the patients to complications such as internal hernias or volvuli. In general, mesenteric closure requires intracorporeal suturing. We describe a simple technique for the closure of the mesentery after surgical resection using polymer-ligating clips. This novel technique seems to minimize the time, effort and risk inherent to the procedure, even after large mesenteric excisions.

摘要

右半结肠切除术后的肠系膜关闭仍然存在争议,并且随着腹腔镜手术的出现,许多外科医生在结直肠切除术后不再常规关闭肠系膜。然而,特别是在引入了完整结肠系膜切除的右半结肠切除术和克罗恩病的广泛系膜切除的回肠结肠切除术等手术之后,由于这些手术所导致的广泛肠系膜缺损肯定会使患者面临诸如内疝或肠扭转等并发症的风险。一般来说,肠系膜关闭需要进行体腔内缝合。我们描述了一种使用聚合物结扎夹进行手术切除后肠系膜关闭的简单技术。即使在进行了较大的肠系膜切除术后,这种新技术似乎也能将手术过程中固有的时间、精力和风险降至最低。

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