直肠和乙状结肠的实验性断流术。

K Fortýn, V Hruban, J Hradecký, J Tichý, P Dvorák, V Horák
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引用次数: 0

摘要

在6头实验猪中,采用直肠血管颅中结扎术对直肠和乙状结肠邻近部分进行断血术(灭活术),同时在小骨盆底部对直肠进行流产关闭,在直肠和乙状结肠交界处进行口腔关闭。断流的直肠没有切除,而是留在原位。建立终末结肠造口术。12周后开腹翻修,切除结肠造口,通过插入吻合术,将结肠末端与肛门粘膜和皮肤缝合,重建肠的连续性。另外2只猪采用结肠造口术对乙状结肠直肠进行断流,12周后通过乙状结肠直肠吻合术进行重建。另外2例在乙状结肠下部进行断流术,乙状结肠-乙状结肠-乙状结肠端侧吻合恢复连续性。所有修正均显示断流坏死节段收缩形成微小纤维组织残留,吻合通畅,结肠-直肠吻合术保留自制。所描述的技术在技术上是简单的,可以作为姑息性手术方法用于直肠和乙状结肠下部无法手术的肿瘤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Experimental devascularization (devitalization) of the rectum and sigmoideum.

In 6 laboratory pigs, devascularization (devitalization) of the rectum and the adjacent part of the sigmoideum was carried out by the vasa rectalia cranialia et media ligatures with simultaneous aboral closure of the rectum at the base of the lesser pelvis and oral closure at the borderline between the rectum and the sigmoideum. The devascularized rectum was not removed but left in situ. Terminal colostomy was established. Laparotomic revision was carried out after 12 weeks, colostomy was removed and continuity of the intestine was reestablished by insertion anastomosis, by suture of the end of the colon to the anal mucosa and skin. In further two pigs, devascularization of the rectosigmoideum was carried out with colostomy and reconstruction was carried out after 12 weeks by procto-sigmoideo-anastomosis. In another 2 animals, devascularization was carried out on the lower part of the sigmoideum and continuity was immediately renewed by end-to-side sigmoideo-sigmo-ideoanastomosis. All revisions indicated that the devascularized necrotic segment shrank to form a minute fibrous tissue residue, anastomosis was patent and continence was retained for colo-proctoanastomosis. The described techniques are technically simple and could be employed as palliative surgical methods for inoperable tumours in the region of the rectum and lower part of the sigmoideum.

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