Gullino D, Ghione S, Cardino L, Giordano O, Gagliano A, Chiarle S
Minerva Chir. 1978;33(13-14):795-816.
The state of the art with regard to surgical management in the prevention and treatment of intestinal occlusion caused by adhesions is described and the various operations proposed are examined. Noble's operation (folding and overcast suture of the intestinal loops)-the first to be proposed requires too much time for its execution. In addition, it restricts loop mobility and thus predisposes to recurrences and complications. The operation of Childs & Philips (folding of the intestine by accordion attachment of the mesentery with transfixing, looped wires) is quicker, but its wires result in a certain degree of vascular and enteric affection. Folding via intubation of the whole of the small intestine with a long catheter, using a nasogastric, gastrostomic or jejunostomic route, is both simple and rapid. It is particularly advisable in non-peritonitic obstruction in children and as a prophylactic measure. Reymond's operation (enteropexy with two simple and fundamental, lateral "virage" sutures) may be segmentary or total, or confined to a few loops. It is very simple and quick. It can always be used and is adaptable to the objective situation in each case. Personal experience with this operation in 69 cases (54 "therapeutic" and 15 "prophylactic") is presented. Two instances of recurrence due to poor technique were noted. It is felt that the operation is extremely satisfactory.
本文描述了粘连所致肠梗阻防治方面的外科治疗现状，并对所提出的各种手术进行了研究。诺布尔手术（肠袢折叠和包埋缝合）——最早提出的手术，实施起来耗时过长。此外，它限制了肠袢的活动，因此易导致复发和并发症。蔡尔兹和菲利普斯手术（通过肠系膜的手风琴式附着和贯穿、环状钢丝对肠进行折叠）更快，但钢丝会导致一定程度的血管和肠道损伤。通过经鼻胃管、胃造口术或空肠造口术用长导管对整个小肠进行插管折叠既简单又快速。在儿童非腹膜炎性梗阻中尤其适用，也可作为一种预防措施。雷蒙德手术（用两根简单且基本的外侧“转向”缝合进行肠固定术）可以是节段性的或完全性的，也可局限于少数肠袢。它非常简单快捷。它总是可以使用，并且能根据每种情况的客观情况进行调整。本文介绍了作者对该手术69例（54例“治疗性”和15例“预防性”）的个人经验。注意到有2例因技术不佳而复发。认为该手术非常令人满意。
