Wang Huipeng, Chen Wenjie, Zhou Xiecheng, Ye Tao, Gong Lifeng, Cai Yuankun
Department of General Surgery, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
J Gastrointest Oncol. 2023 Feb 28;14(1):213-219. doi: 10.21037/jgo-22-1284. Epub 2023 Feb 8.
Ileostomy is often used in low rectal cancer to protect the anastomosis and reduce the incidence of anastomotic leakage. However, the closure of the stoma causes physical and psychological damage to patients. An intestine diversion tube with a double-balloon was designed to remove the need for ileostomy and a secondary surgery, and we sought to verify its effectiveness and safety.
An intestine diversion tube with a double-balloon was designed, and the experiment was performed in 5 groups of experiment pigs by the same group of physicians. The tube was placed into the ileum through the cecum during surgery. All the animals were anatomized after being anesthetized on the 14th day postoperatively to check the anastomosis and abdominal cavity. The postoperative complications included anastomotic leakage, abdominal or pelvic infection, anastomotic stenosis, postoperative bleeding, intestinal obstruction, reoperation, electrolyte disorder, drainage tube blockage, and drainage tube fall off.
No serious postoperative complications occurred in the 5 animal groups. The average daily drainage tube volume was 188.6 mL, the average drainage tube removal time was 13.4 days, and the average first defecation time was 2.6 days. Postoperative drainage was smooth, and no anastomotic leakage, other complications, or animal deaths occurred.
The use of the intestine diversion tube with a double-balloon was feasible in animal experiments and was safe and effective. The procedure is simple, and suitable for popularization and application in the clinic.
回肠造口术常用于低位直肠癌以保护吻合口并降低吻合口漏的发生率。然而,造口关闭会给患者带来身体和心理伤害。设计了一种双球囊肠转流管以消除回肠造口术及二次手术的需求,我们旨在验证其有效性和安全性。
设计了一种双球囊肠转流管,由同一组医生在5组实验猪身上进行实验。手术期间通过盲肠将该管置入回肠。术后第14天对所有动物进行麻醉后解剖,检查吻合口及腹腔情况。术后并发症包括吻合口漏、腹腔或盆腔感染、吻合口狭窄、术后出血、肠梗阻、再次手术、电解质紊乱、引流管堵塞及引流管脱落。
5组动物均未发生严重术后并发症。平均每日引流管引流量为188.6 mL,平均引流管拔除时间为13.4天,平均首次排便时间为2.6天。术后引流顺畅,未发生吻合口漏、其他并发症及动物死亡情况。
双球囊肠转流管在动物实验中使用可行,且安全有效。该操作简单,适合在临床推广应用。