Chetrafilov D, Stamenov S, Khandzhiev P, Mangŭrov I
Probl Khig. 1980;8:121-38.
Over the period 1963 to July 30, 1978 a total of 312 patients with clinical picture of acute or subacute mechanical ileus were admitted to the surgical department of the district hospital in Targovishte, and 227 of them were operated on as emergency cases. During the first period covering 1963-1970, the number of operated patients amounted to 78 of which eighteen - a 23.07 per cent lethality. During the second out of 149 patients operated on twenty-three died which makes a 15.63 per cent lethality. A detailed analysis is made of the factors influencing the treatment results, and the conclusion is reached that the age of patients, cause of obstruction and level of ileus have an essential practical bearing. It is assumed that in small intestinal ileus the 11.95 per cent lethality recorded among the 92 operated patients, against 26.3 per cent in the first period, is due first and foremost to the radical operative interventions applied, aimed not only to tackle the ileus problem but also to remove the prime cause of ileus, as well as to the measures undertaken - mesenteriplication after Childs-Philips and its modification - to prevent early and late recurrence of the ileus. The tactics adopted in the various forms of small intestinal ileus are analyzed in detail. The operative methods used and lethality recorded in colonic ileus are also analyzed. Here the condition presents volvulus of the sigma and carcinoma of the colon. The immediate results of the applied radical and palliative operations are evaluated. Radical surgery of the right half of the colon is more justified. Ileus of the left half of the colon demands meticulous assessment of the local status prior to take the decision about undertaking radical intervention on passage indications. The indications for resection of the colon and its completion with anastomosis or provisory preternatural anus are discussed. The lethality rate recorded in 57 patients operated for colonic ileus during the second period amounts to 21 per cent.
在1963年至1978年7月30日期间，共有312例临床表现为急性或亚急性机械性肠梗阻的患者被收治到特尔戈维什泰地区医院外科，其中227例作为急诊病例接受了手术。在1963年至1970年的第一阶段，接受手术的患者有78例，其中18例死亡，死亡率为23.07%。在第二阶段，149例接受手术的患者中有23例死亡，死亡率为15.63%。对影响治疗结果的因素进行了详细分析，得出的结论是患者年龄、梗阻原因和肠梗阻部位具有至关重要的实际影响。据推测，在小肠梗阻中，92例接受手术的患者记录的死亡率为11.95%，而第一阶段为26.3%，这首先归因于所采用的根治性手术干预措施，其目的不仅是解决肠梗阻问题，还在于消除肠梗阻的根本原因，以及所采取的措施——Childs-Philips法及其改良后的肠系膜折叠术，以防止肠梗阻的早期和晚期复发。详细分析了各种形式小肠梗阻所采用的策略。还分析了结肠梗阻所采用的手术方法和记录的死亡率。在此，病情表现为乙状结肠扭转和结肠癌。对所应用的根治性和姑息性手术的近期结果进行了评估。右半结肠的根治性手术更具合理性。左半结肠梗阻在决定是否根据通行指征进行根治性干预之前，需要对局部情况进行细致评估。讨论了结肠切除及其吻合或临时性人工肛门完成的指征。第二阶段57例接受结肠梗阻手术的患者记录的死亡率为21%。
