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首页> 外文期刊>World Journal of Gastroenterology >Exteriorized colon anastomosis for unprepared bowel: An alternative to routine colostomy
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Exteriorized colon anastomosis for unprepared bowel: An alternative to routine colostomy

机译：结肠结肠吻合术无准备的肠：常规结肠造口术的替代方法

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AIM: To see the possibility of avoiding routine colostomy in patients presenting with unprepared bowel. METHODS: The cohort is composed of 103 patients, of these, 86 patients presented as emergencies (self-inflected and iatrogenic colon injuries, stab wounds and blast injury of the colon, volvulus sigmoid, obstructing left colon cancer, and strangulated ventral hernia). Another 17 patients were managed electively for other colon pathologies. During laparotomy, the involved segment was resected and the two ends of the colon were brought out via a separate colostomy wound. One layer of interrupted 3/0 silk was used for colon anastomosis. The exteriorized segment was immediately covered with a colostomy bag. Between the 5* and 7th postoperative day, the colon was easily dropped into the peritoneal cavity. The defect in the abdominal wall was closed with interrupted nonabsorbable suture. The skin was left open for secondary closure. RESULTS: The mean hospital stay (± SD) was 11.5 ± 2.6 d (8-20 d). The exteriorized colon was successfully dropped back into the peritoneal cavity in all patients except two. One developed a leak from oesophago-jejunostomy and from the exteriorized colon. She subsequently died of sepsis and multiple organ failure (MOF). In a second patient the colon proximal to the exteriorized anastomosis prolapsed and developed severe serositis, an elective ileo-colic anastomosis (to the left colon) was successfully performed. CONCLUSION: Exteriorized colon anastomosis is simple, avoids the inconvenience of colostomy and can be an alternative to routine colostomy. It is suitable where colostomy is socially unacceptable or the facilities and care is not available.
机译：目的：了解在肠未准备好的患者中避免常规结肠造口术的可能性。方法：该队列包括103例患者，其中86例为紧急情况（自发性和医源性结肠损伤，结肠刺伤和爆炸伤，乙状结肠乙状结肠，阻塞性左结肠癌和绞窄性腹疝）。另有17例患者因其他结肠病变而接受选择性治疗。在剖腹手术中，切除受累部分，并通过单独的结肠造口术伤口将结肠的两端引出。一层间断的3/0丝用于结肠吻合。立即用结肠造瘘袋覆盖外部部分。在术后第5天至第7天之间，结肠很容易掉入腹膜腔内。腹壁缺损用不可吸收的缝合线封闭。保持皮肤开放以进行二次封闭。结果：平均住院时间（±SD）为11.5±2.6 d（8-20 d）。除两名外，所有患者均成功将外化结肠回落至腹膜腔。一个人因食管空肠造口术和外部结肠发漏。她随后死于败血症和多器官功能衰竭（MOF）。在第二例患者中，靠近外部吻合的结肠脱垂并发展为严重的浆膜炎，成功地进行了选择性回肠结肠吻合术（左侧结肠）。结论：结肠结肠吻合术简单易行，避免了结肠造口术的不便，可替代常规结肠造口术。当结肠造口术在社会上是不可接受的或没有设施和护理时，它是合适的。

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