枪伤与德洛耶斯程序:病例报告与文献综述。

Cengiz Ceylan
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引用次数: 0

摘要

在大肠切除术后,不一定能进行大肠吻合术。Deloyers手术涉及右侧结肠的转位,被认为是一种可行的解决方案。本报告旨在通过回顾 2010 年至 2023 年间的病例,讨论在何种情况下实施 Deloyers 手术,并评估术后早期和晚期的效果。一名 22 岁的女性患者因枪支伤害导致主要器官和组织缺失(乙状结肠、降结肠、横结肠和肠系膜受伤),在最初的损伤控制手术后的修复手术中采用了 Deloyers 手术。手术过程包括移动盲肠和右侧结肠,在回结肠动脉栓上进行颅尾旋转,然后进行阑尾切除,并使用圆形订书机进行结肠直肠吻合术。术后随访期间没有出现并发症。术后第14天,患者出院,每天排便4次,服用2.5毫克盐酸地芬诺酯和0.025毫克硫酸阿托品。在 6 个月的随访中,排便次数减少到每天两次,无需药物治疗。考虑到扩大左结肠切除术后患者的功能效果,Deloyers 手术的相关发病率较低,是一种可行的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Firearm injury and the Deloyers procedure: case report and literature review.
Following extended colon resections, it may not always be possible to perform colorectal anastomosis. The Deloyers procedure, which involves the transposition of the right colon, has been identified as a viable solution. This report aims to discuss the circumstances under which the Deloyers procedure was performed, as well as to evaluate the early and late postoperative outcomes, by reviewing cases conducted between 2010 and 2023. In a 22-year-old female patient who suffered major organ and tissue loss (with injuries to the sigmoid colon, descending colon, transverse colon, and mesentery) due to a firearm injury, the Deloyers procedure was applied during restorative surgery following initial damage control surgery. The procedure involved mobilizing the cecum and right colon, performing a cranio-caudal rotation over the ileocolic artery pedicle, followed by an appendectomy, and creating a colorectal anastomosis using circular staplers. There were no complications during the postoperative follow-ups. By the 14th postoperative day, the patient was discharged and experienced bowel movements four times a day, managed with 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. At the 6-month follow-up, the frequency of bowel movements had decreased to twice daily without the need for medical treatment. Given the functional outcomes in patients after extended left colectomies, the Deloyers procedure, with its low associated morbidity, stands out as a viable option.
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