Biondo S, Jaurrieta E, Jorba R, Moreno P, Farran L, Borobia F, Bettonica C, Poves I, Ramos E, Alcobendas F
Department of Surgery, Ciudad Sanitaria y Universitaria de Bellvitge, University of Barcelona, Spain.
Br J Surg. 1997 Feb;84(2):222-5.
The surgical management of left colonic emergencies has evolved in the past few decades. Recently, there has been increasing interest in resection with primary anastomosis in selected cases. The aim of this study was to evaluate the differences in outcome in patients with peritonitis or obstruction treated by resection, on-table lavage and primary anastomosis of the left colon.
Between January 1992 and August 1995, 212 patients underwent emergency operation for a distal colonic lesion: 97 presented with peritonitis, 113 with obstruction and two with other indications. Intraoperative colonic lavage was performed in 37 patients with obstruction and in 24 with an acute intra-abdominal inflammatory process.
The postoperative mortality rate was 5 per cent. The incidence of clinical anastomotic leakage was 5 per cent. Wound infection was observed in ten patients (16 per cent), more often in those with peritonitis (P = 0.03). The overall mean(s.d.) hospital stay was 15(9) days.
Resection, on-table lavage and primary anastomosis constitute the operation of choice for selected patients with left colonic emergency.
在过去几十年中，左半结肠急症的外科治疗方法不断演变。最近，对于某些特定病例行一期吻合切除术的兴趣日益增加。本研究的目的是评估左半结肠切除、术中灌洗及一期吻合治疗腹膜炎或肠梗阻患者的疗效差异。
1992年1月至1995年8月期间，212例患者因远端结肠病变接受急诊手术：97例为腹膜炎，113例为肠梗阻，2例为其他指征。37例肠梗阻患者及24例急性腹腔内炎症患者术中进行了结肠灌洗。
术后死亡率为5%。临床吻合口漏发生率为5%。10例患者（16%）发生伤口感染，腹膜炎患者中更常见（P = 0.03）。总体平均（标准差）住院时间为15（9）天。
对于选定的左半结肠急症患者，切除、术中灌洗及一期吻合是首选的手术方式。
