Champault G, Patel J C
J Chir (Paris). 1978 Dec;115(12):689-700.
Colonic surgery is still relatively lethal and there is a morbidity related to the breakdown of sutures which seems linked to the quality of the colonic preparation. Although everyone agrees today that this preparation is necessary, the choice of the procedure remains debated. High flow rate digestive irrigation with a solution of 10% mannitol presents numerous advantages compared with standard preparations. It definitely ensures better emptying of the colon; its role on the colonic flora is variable, minor and transient, which raises the problem of complementary antibiotic therapy. The encouraging results with regard to septic post-operative complications should lead one to extend the indications and to undertake random studies after definition of strict criteria of comparison on large series to find the procedure best adapted to each situation.
结肠手术的致死率仍然相对较高,且存在与缝线破裂相关的发病率,这似乎与结肠准备的质量有关。尽管如今大家都认同这种准备是必要的,但手术方式的选择仍存在争议。与标准准备方法相比,用10%甘露醇溶液进行高流速消化灌洗有诸多优点。它确实能确保结肠更好地排空;其对结肠菌群的作用是可变的、轻微的且短暂的,这就引发了辅助抗生素治疗的问题。关于术后感染性并发症的令人鼓舞的结果应促使人们扩大适应证,并在针对大量病例确定严格的比较标准后进行随机研究,以找到最适合每种情况的手术方式。