腹腔镜下缩短固定系膜治疗乙状结肠冗长合并肠扭转分析

Laparoscopic shortening of the fixed mesothelioma in the treatment of redundant sigmoid colon with long bowel torsion

目的探讨腹腔镜下缩短固定系膜治疗乙状结肠冗长并肠扭转的有效性、可行性和安全性。方法选择2007年1月至2016年12月中山大学附属第五医院收治的成人乙状结肠冗长并扭转患者21例,采用腹腔镜下复位,沿肠管和系膜方向间断褥式缝合系膜,然后在左侧将乙状结肠靠近结肠带间断缝合并固定。术后随访分析患者排便改善情况和并发症,评价该术式的疗效。结果全部病例无并发症出现,随访1年,未再发生乙状结肠扭转并肠梗阻。17例(81.0%)便秘得到不同程度改善,其中8例(38.1%)完全有效,9例(42.9%)部分有效;4例(19.0%)排便无明显改善。结论腹腔镜下缩短固定系膜治疗乙状结肠冗长并肠扭转有效、可行、安全和简单,具有一定临床价值。

Objective To evaluate the efficacy, feasibility and safety of laparoscopic shortening of fixed mesenteric in the treatment of redundant sigmoid colon with long and intestine torsion. Methods From January 2007 to December 2016, twenty-one cases of redundant sigmoid colon with long and intestine torsion were studied from the Fifth Affiliated Hospital of Sun Yat-sen University. The patients underwent laparoscopic reduction in success, along the intestine and mesangium, and then repeatedly sutured and fixed on the left side of the sigmoid colon close to the intercostal on the pelvic wall. The defecation improvement and complications were analyzed to evaluate the curative effect of this operation. Results There were no complications in all cases. No recurrence of sigmoid distention or intestinal obstruction occurred in 1 year, and 17 cases（81.0%） had different degrees of improvement. Among them, 8 cases（38.1%） were completely effective, and 9（42.9%） were partly effective; 4 cases（19.0%） had no obvious improvement in defecation. Conclusion Laparoscopic shortening and fixing mesothelioma is effective, feasible, safe and simple, and has certain clinical value in the treatment of redundant sigmoid colon.