临床外科杂志 ›› 2020, Vol. 28 ›› Issue (5): 447-450.doi: 10.3969/j.issn.1005-6483.2020.05.013

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顺蠕动侧侧肠吻合和功能性端端肠吻合在Crohn's病消化道重建中的应用

  

  1. 武汉大学中南医院结直肠肛门外科/武汉大学中南医院炎症性肠病外科诊疗中心/湖北省肠病医学临床研究中心/肠病湖北省重点实验室
  • 出版日期:2020-05-20 发布日期:2020-05-20

Application of sidetoside isoperistaltic anastomosis and functional endtoend anastomosis in digestive tract reconstruction of Crohn's disease

  • Online:2020-05-20 Published:2020-05-20

摘要: 目的:比较顺蠕动侧侧肠吻合和功能性端端吻合方式在Crohn's病(Crohn's disease,CD)肠管切除后消化道重建中的应用效果。方法:回顾性分析2017年3月~2019年10月接受肠切除手术的CD病人的消化道重建方式及临床、随访资料。结果:72例CD病人接受肠管吻合78次,其中顺蠕动侧侧肠吻合(sidetoside isoperistaltic anastomosis,SSIA)63次(小肠小肠44次,小肠结肠10次,结肠结肠9次),功能性端端肠吻合(functional endtoend anastomosis,FEEA)15次(小肠小肠4次,小肠结肠7次,结肠结肠4次)。吻合口近端肠管造口7例。SSIA完成时间(32±14)分钟,FEEA完成时间(19±6)分钟,接受SSIA的病人术后住院时间7~14 天(平均9.1天); 接受FEEA的病人术后住院时间8~15天(平均8.7天)。术后随访30天。1例接受FEEA+近端造口的病人发生吻合口漏。两种吻合方式均无吻合口狭窄发生。结论:SSIA和FEEA均适用于CD肠管切除术后的消化道重建。但在肠系膜肥厚或横结肠及左半结肠的吻合选择SSIA可能更有优势。

关键词: 克罗恩病;顺蠕动侧侧肠吻合;功能性端端吻合;并发症 

Abstract: Objective:To evaluate the sidetoside isoperistaltic anastomosis and functional endtoend anastomosis in digestive tract reconstruction of Crohn's disease.Methods:Clinical and followup data of CD patients who underwent intestinal resection from March 2017 to October 2019 were retrospectively analyzed.Result:Seventytwo CD patients underwent bowel anastomosis 78 times,in which sidetoside isoperistaltic anastomosis(SSIA)63 times(small intestinesmall intestine 44 times,small intestinecolon 10 times,and the coloncolon 9 times),and functional endtoend anastomosis(FEEA)15 times(small intestinethe small intestine 4 times,small intestinecolon 7 times,and coloncolon 4 times).Anastomotic proximal enterostomy occured in 7 cases.SSIA completion time was(32±14)min,and FEEA completion time(19±6)min.The postoperative hospitalization time of patients receiving SSIA was 7~14 days(mean 9.1 days).Patients receiving FEEA were hospitalized for 8~15 days(mean 8.7 days).One patient receiving FEEA and proximal stoma developed anastomotic leakage.There was no anastomotic stenosis in those two anastomotic methods.Conclusion:Both SSIA and FEEA are suitable for gastrointestinal reconstruction after CD intestinal resection.However,SSIA may be preferred for mesenteric hypertrophy or anastomosis of the transverse and left hemicolon.

Key words: Crohn's disease, 〓sidetoside isoperistaltic anastomosis, 〓functional endtoend anastomosis, 〓complications

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