Williams N S, Hughes S F, Stuchfield B
Surgical Unit, Royal London Hospital, Whitechapel, UK.
Lancet. 1994 May 28;343(8909):1321-4. doi: 10.1016/s0140-6736(94)92467-8.
We describe a new operation for the treatment of rectal evacuatory disorders: a continent colonic conduit, incorporating an intussuscepted valve, was constructed from the sigmoid colon. Intubation of the conduit allowed irrigation and evacuation of the distal colon and rectum. Initially all 10 patients reported a reduction in time taken and the discomfort involved in completing evacuation. The number of stools passed per week increased in 9 out of 10 patients, from a median of 1.5 (range 0.25-7) to a median of 7 (range 3-7) postoperatively. Subsequently, 3 patients developed complications, 2 of whom required conversion to an ileostomy. Overall, the colonic conduit procedure was successful in treating the rectal evacuatory disorder in 7 patients, failed in 2, and 1 patient has a temporary defunctioning ileostomy. The procedure is a relatively simple surgical alternative for the treatment of a condition which is often resistant to conservative measures.
采用乙状结肠构建了一种带有套叠瓣膜的可控结肠造瘘管。通过对该造瘘管进行插管可实现远端结肠和直肠的冲洗及排空。最初，所有10例患者均报告完成排空所需时间减少且不适感减轻。10例患者中有9例每周排便次数增加，从术前的中位数1.5次（范围0.25 - 7次）增至术后的中位数7次（范围3 - 7次）。随后，3例患者出现并发症，其中2例需要改为回肠造口术。总体而言，结肠造瘘管手术在7例患者中成功治疗了直肠排空障碍，2例失败，1例患者有临时失功性回肠造口术。该手术是一种相对简单的外科替代方法，用于治疗通常对保守措施耐药的病症。
