Brief D K, Brener B J, Goldenkranz R, Alpert J, Yalof I, Parsonnet V
Am Surg. 1983 Feb;49(2):66-72.
Subtotal colectomy (STC) is a safe operation because operative mortality rates are as good as, if not better than, conventional segmental colon resections. It is no more difficult to perform than conventional segmental resections. Suture line complications, such as fecal fistulas and suture line recurrences, are not as common before as they are after colocolic anastomoses. In addition to being used in cases with known synchronous carcinomas, and carcinoma associated with polyps, STC should be considered in selected patients with obstructing or partially obstructing lesions of the sigmoid or left colon when complete evaluation of the proximal colon has not been possible. STC can be combined with a preliminary transverse colostomy for obstructing left colon lesions when appropriate evaluation demonstrates suitable indications for the resection of the colostomy as a one-stage procedure with ileocolic anastomosis. It also should be considered if there is significant distal sigmoidal diverticular disease associated with proximal carcinomas. Statistically, STC does not appear to be indicated as a prophylactic operation to avoid the development of metachronous colon cancer when the entire colon can be surveyed colonoscopically to assure that there is no associated neoplasm.
次全结肠切除术（STC）是一种安全的手术，因为其手术死亡率即便不比传统节段性结肠切除术更好，至少也与之相当。它的操作难度并不高于传统节段性切除术。缝合线相关并发症，如粪瘘和缝合线复发，在结肠结肠吻合术前不像术后那么常见。除了用于已知同时性癌以及与息肉相关的癌的病例外，当无法对近端结肠进行全面评估时，对于乙状结肠或左半结肠有梗阻或部分梗阻性病变的特定患者，也应考虑行STC。当适当评估显示有合适指征将结肠造口术切除作为回结肠吻合术的一期手术时，STC可与初步横结肠造口术联合用于梗阻性左半结肠病变。如果存在与近端癌相关的显著远端乙状结肠憩室病，也应考虑行STC。从统计学角度来看，当能够通过结肠镜检查整个结肠以确保不存在相关肿瘤时，STC似乎不适合作为预防异时性结肠癌发生的预防性手术。
