Reemst P H, Kuijpers H C, Wobbes T
Department of Surgery, Diakonessenhuis Eindhoven, Recklinghausen, Germany.
Eur J Surg. 1998 Jul;164(7):537-40; discussion 541-2. doi: 10.1080/110241598750005912.
To assess complications and functional results of emergency subtotal colectomy with ileocolic anastomosis for acute left-sided colonic obstruction.
Retrospective study.
University hospital, Netherlands.
37 patients with acute left-sided colonic obstruction.
Emergency subtotal colectomy with immediate anastomosis (n = 20), Hartmann's procedure (n = 13) or double-loop transverse colostomy (n = 4).
Mortality, morbidity, duration of hospital stay, frequency of defecation, and continence.
Morbidity after subtotal colectomy was 10% (n = 2) and mortality 0. There was one anastomotic dehiscence that required a temporary ileostomy. Mean hospital stay was 15 days (range 10-31). All had adequate continence. After 6 weeks mean frequency of defecation was 3/24 hrs (range 2-6). 9 patients died within 2 years of metastatic disease.
Subtotal colectomy with ileocolic anastomosis is a suitable procedure for treating left-sided colonic obstruction provided that pelvic floor function is adequate and a skilled surgeon is available.
评估急诊次全结肠切除术加回结肠吻合术治疗急性左侧结肠梗阻的并发症及功能结果。
回顾性研究。
荷兰大学医院。
37例急性左侧结肠梗阻患者。
急诊次全结肠切除术并立即吻合（n = 20）、Hartmann手术（n = 13）或双袢横结肠造口术（n = 4）。
死亡率、发病率、住院时间、排便频率及控便能力。
次全结肠切除术后发病率为10%（n = 2），死亡率为0。有1例吻合口裂开，需行临时回肠造口术。平均住院时间为15天（范围10 - 31天）。所有患者控便能力良好。6周后平均排便频率为每24小时3次（范围2 - 6次）。9例患者在2年内死于转移性疾病。
只要盆底功能良好且有经验丰富的外科医生，次全结肠切除术加回结肠吻合术是治疗左侧结肠梗阻的合适术式。
