摘要
目的：研究一种彻底快速而毫不污染手术野的术中肠减压方法，以便提高手术的安全性。方法：游离系膜后，钳夹下将拟切除肠段的下端先切断，将其近侧断端置入并固定于粘附在手术床边的塑料袋中；松开肠钳，肠内容物自由流入袋内；双手交替推挤膨胀的肠段，由近而远，由小肠向大肠，直至大、小肠的内容物彻底排空。钳夹下切断上端，移除切下的肠段和充满粪便的塑料袋。结果：使用本法行肠减压术，一期切除急性梗阻的左结肠癌３１例，均未发生吻合口漏，创口一期愈合。另有６例肝段切除同时切除未作肠道准备的结肠癌，亦取得同样结果。同法亦用于各种急性小肠梗阻，均未造成腹腔污染。结论：本法可推荐为术中肠减压的首选方法。
Objective:thorough,prompt enteral decompression technique without contamination was developed to ensure safety for emergent colon resection and primary anastomosis.Method:after its mesentery was isolated,the "to-be-resected colon segment" was cut at its lower end,then the proximal cut end was put into a plastics bag which was adhered to one side of operating table.Released the clamp which had been applied to the cut end,the bowel content could flow into this bag.The operator could squeeze the bowel alternatively by two hands,from proximal forward,and from small bowel to large bowel,until the entire bowel content was fully discharged.Then the upper end of this "to-be-resected colon segment" was cut,and was removed together with the plastic bag.Results:31 cases of left colon cancer with acute obstruction were decompressed with this technique.They all recovered smoothly,without anastomosis fistula.Another 6 cases of hepatic segmetectomy with incidental colonectomy were decompressed with this technique,and had the same results.This technique was also used in different kinds of acute small bowel obstruction with good results.Conclusion:it is advocated that this technique be the first choice for intraoperative enteral decompression.
出处
《中国实用外科杂志》
CSCD
北大核心
1998年第11期664-665,共2页
Chinese Journal of Practical Surgery
关键词
肠减压术
左半结肠
结肠肿瘤
结肠梗阻
enteral decompression
left colon
one-stage anastomosis
peritioneal contamination
