结肠癌急性梗阻一期切除吻合的肠减压方法

Enteral decompression for one - stage resection of colon cancer with acute obstruction

目的 介绍一种彻底快速而毫不污染手术野的术中肠减压方法,以便提高手术的安全性。方法 游离系膜后,钳夹下将切除肠段的下端先切断,将其近侧端置入并固定于粘附在手术床边的塑料袋中;松开肠钳,肠内容物自由流入袋内;双手交替推挤膨胀的肠段,由近而远,由小肠至大肠,直至大、小肠的内容物彻底排空。钳夹下切除上端,移除切下的肠段和充满粪便的塑料袋。结果 使用本法行肠减压术,一期切除的左半结肠癌和各类小肠急性梗阻,均未发生吻合口漏和腹腔污染。结论 本法可推荐为术中肠减压的首选方法。

Objective Thorough prompt enteral decompression technique without contamination was developed to ensure safety for emergent colon resection and primary anastomosis. Methods After its mesentery was isolated , the To - be resected colon segment' was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of operating talbe. Released the clamp which had been applied to the cut end, the bowel content could flow into this bag. The operator could squeeze the bowel alternatively by twe hands, from proximal forward and from small bower to colon, until the entire bowel content was full discharged. Then the uper end of this 'To-be resected colon segment was cut and was removed together with the plastic bag. Results With this technique, all the left colon cancer and small bowel with acute obstruction were decompressed without anastomosis fistula and contamination. Conclusions It is advocated that this technique be the first choice for intraoperative enteral decompression .