Sahlin Y, Myrvold H E, Wiig J N
Kirurgisk avdeling Regionsykehuset i Trondheim.
Tidsskr Nor Laegeforen. 1994 May 10;114(12):1427-8.
Primary bowel anastomosis was performed after an on table lavage procedure in 29 patients who required surgery for colonic lesions. 13 patients were operated in the acute or subacute stage and 16 had inadequately prepared colons at the time of elective operations. The diagnoses were cancer of the colon in 23 patients, diverticulitis in three, stoma stricture in two and colonic bleeding in one. There were 26 left-sided colonic resections, two transverse colonic resections and one right-sided hemicolectomy. The procedure prolonged the operation time by 38 min. (median), range 16-80 min. The rate of complications was 14%, and there was no mortality. None of the patients presented clinical signs of anastomotic leakage. It is concluded that primary colonic anastomosis after on table lavage is a safe and reliable alternative to staged operations. It saves the patients the discomfort of a temporary stoma and possible morbidity from further operations.
对29例因结肠病变需要手术的患者在术中灌洗后进行了一期肠道吻合术。13例患者在急性或亚急性期接受手术,16例在择期手术时结肠准备不充分。诊断为结肠癌23例,憩室炎3例,造口狭窄2例,结肠出血1例。行左侧结肠切除术26例,横结肠切除术2例,右侧半结肠切除术1例。该操作使手术时间延长了38分钟(中位数),范围为16 - 80分钟。并发症发生率为14%,无死亡病例。所有患者均未出现吻合口漏的临床体征。结论是术中灌洗后一期结肠吻合术是分期手术的一种安全可靠的替代方法。它避免了患者临时造口的不适以及再次手术可能带来的发病率。