Steer M L, Glotzer D J
Arch Surg. 1980 Jan;115(1):87-9. doi: 10.1001/archsurg.1980.01380010073017.
Two patients with malignant upper gastrointestinal-to-colon fistulas had palliative operations utilizing the exclusion bypass principle. This principle entails isolating the affected portions of the colon from the remaining large intestine and anastomosing it to itself. Exclusion bypass reduces bacterial contamination of the upper tract (which is the important mechanism for the unrelenting diarrhea and malnutrition), eliminates prograde shunting, which can contribute to symptoms in malignant fistulas, and avoids the potential for closed-loop obstruction.
两名患有恶性上消化道至结肠瘘的患者接受了采用旷置旁路原则的姑息性手术。该原则包括将结肠的受影响部分与其余大肠隔离，并将其自身吻合。旷置旁路可减少上消化道的细菌污染（这是导致持续性腹泻和营养不良的重要机制），消除可能导致恶性瘘管症状的顺行分流，并避免闭环梗阻的可能性。
