结直肠癌病人术前肠道准备欠清洁的术中补救措施
作者：李学勇 王远明 吴云龙 张鸿彬
单位：317300 浙江省仙居县中医院
关键词：结肠；直肠；肠道准备
浙江临床医学000108
摘 要：目的：探讨一种肠道准备欠清的术中补救措施，以便提高结直肠癌手术的安全性。方法：游离肠系膜后，术者用中指和食指夹住拟切除肠段以下的大肠肠壁，自远而近滑行，彻底将肠内容物排人该肠段内，用二把紧靠的直钳钳夹下切端，暂不切断；同样方法将拟切除肠段以上的肠内容物自近而远推挤入该肠段内，并钳夹上端，然后切断上、下端，移去充满粪液的切除肠段。远侧及近侧段肠内注入PVP碘等处理后再作吻合。结果：使用本法作术中补救措施，38例患者均作一期肠切除吻合，未发生吻合口瘘及切口感染。结论：本法可作为结直肠癌病人术前肠道准备欠清洁时的术中补救方法。
A Intraoperative Remedy Step for Colorectal Cancer is not Porper Clean before Operation
Li Xueyong
Abstract：Objective: We intend to offer an intraoperative remedial measure in patients who are scheduled to have colon resection, but found to be unsatisfactory in his bowel preparation. Methods: After the colon to be resected and its mesentery are isolated, the operater may milk back the contents in the colon distal to the resection line by his index and middle finger to the segment of colon to be resected, and the distal end is double clamped. Same maneuver is applied in the proximal part of the colon by milking forward its contents to the segment of colon to be resected, and the colon is clamped as before. Finally the colon is resected betwwen the two clamps on either side and primary anastomosis completed. Results: 19 patients with colorectal cancer were operated by this technique without postoperative anastomotic leakage and wound infection. Conclusion: A simple intraoperative remedial measure is advocated in case if the preoperative preparation of the bowel is not adequate enough for colon resection and primary anastomosis.
Keywords：colon rectum enteral preparation
参考文献：
[1]朱华生摘.结直肠手术病人术前肠道准备的前瞻性随机化研究(英).国外医学外科学分册，1995，(22)：58.
[2]张延龄综述.梗阻性左半结肠癌的治疗近展.国外医学外科学分册，1995，(22)：133.
[3]王 琮.肠切除并一期肠吻合术治疗急性左半结肠完全性梗阻48例临床分析.现代外科手术学杂志，1998，(3)：28.
[4]刘玉林，急性癌性结肠梗阻的诊断与治疗.中国实用外科杂志.1998，(18)：668., 百拇医药
单位：317300 浙江省仙居县中医院
关键词：结肠；直肠；肠道准备
浙江临床医学000108
摘 要：目的：探讨一种肠道准备欠清的术中补救措施，以便提高结直肠癌手术的安全性。方法：游离肠系膜后，术者用中指和食指夹住拟切除肠段以下的大肠肠壁，自远而近滑行，彻底将肠内容物排人该肠段内，用二把紧靠的直钳钳夹下切端，暂不切断；同样方法将拟切除肠段以上的肠内容物自近而远推挤入该肠段内，并钳夹上端，然后切断上、下端，移去充满粪液的切除肠段。远侧及近侧段肠内注入PVP碘等处理后再作吻合。结果：使用本法作术中补救措施，38例患者均作一期肠切除吻合，未发生吻合口瘘及切口感染。结论：本法可作为结直肠癌病人术前肠道准备欠清洁时的术中补救方法。
A Intraoperative Remedy Step for Colorectal Cancer is not Porper Clean before Operation
Li Xueyong
Abstract：Objective: We intend to offer an intraoperative remedial measure in patients who are scheduled to have colon resection, but found to be unsatisfactory in his bowel preparation. Methods: After the colon to be resected and its mesentery are isolated, the operater may milk back the contents in the colon distal to the resection line by his index and middle finger to the segment of colon to be resected, and the distal end is double clamped. Same maneuver is applied in the proximal part of the colon by milking forward its contents to the segment of colon to be resected, and the colon is clamped as before. Finally the colon is resected betwwen the two clamps on either side and primary anastomosis completed. Results: 19 patients with colorectal cancer were operated by this technique without postoperative anastomotic leakage and wound infection. Conclusion: A simple intraoperative remedial measure is advocated in case if the preoperative preparation of the bowel is not adequate enough for colon resection and primary anastomosis.
Keywords：colon rectum enteral preparation
参考文献：
[1]朱华生摘.结直肠手术病人术前肠道准备的前瞻性随机化研究(英).国外医学外科学分册，1995，(22)：58.
[2]张延龄综述.梗阻性左半结肠癌的治疗近展.国外医学外科学分册，1995，(22)：133.
[3]王 琮.肠切除并一期肠吻合术治疗急性左半结肠完全性梗阻48例临床分析.现代外科手术学杂志，1998，(3)：28.
[4]刘玉林，急性癌性结肠梗阻的诊断与治疗.中国实用外科杂志.1998，(18)：668., 百拇医药