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结直肠癌病人术前肠道准备欠清洁的术中补救措施
A Intraoperative Remedy Step for Colorectal Cancer is not Porper Clean before Operation
【摘要】 目的:探讨一种肠道准备大清的术中补救措施,以便提高结直肠癌手术的安全性。方法:游离肠系膜后,术者用中指和食指夹住拟切除肠段以下的大肠肠壁,自远而近滑行,彻底将肠内容物排入该肠段内,用二把紧靠的直钳钳夹下切端,暂不切断;同样方法将拟切除肠段以上的肠内容物自近而远推挤入该肠段内,并钳夹上端,然后切断上、下端,移去充满粪液的切除肠段。远侧及近侧段肠内注入PVP碘等处理后再作吻合。结果:使用本法作术中补救措施,38例患者均作一期肠切除吻合,未发生吻合口瘘及切口感染。结论:本法可作为结直肠癌病人术前肠道准备欠清洁时的术中补救方法。
【Abstract】 Objective: We intend to offer an intraoperative remedial measure in patients who are scheduled to have colon resection, but found to be unsatisfactory in his bowel preparation. Methods: After the colon tO be resected and its mesentery are isolated, the operater may milk back the contents in the colon distal to the resection line by his index and middle finger to the segment of colon to be resected, and the distal end is double clamped. Same maneuver is applied in the proximal part of the colon by milking forward its contents to the segment of colon to be resected, and the colon is clamped as before. Finally the colon is resected betwwen the two clamps on either side and primary anastomosis completed. Results: 19 patients with colorectal cancer were operated by this technique without postoperative anastomotic leakage and wound infection. Conclusion: A simple intraoperative remedial measure is advocated in case if the preoperative preparation of the bowel is not adequate enough for colon resection and primary anastomosis.
- 【文献出处】 浙江临床医学 ,ZHEJIANG CLINICAL MEDICAL JOURNAL , 编辑部邮箱 ,2000年01期
- 【分类号】R735.3
- 【下载频次】22