结肠切除术

Abstract］ objective to discuss the influencing factors of healing up of anastomosis between traditional and morden ideas and question the more reasonable method of intestinal tract preparation in stage one operation.methods twenty-six patients with colon cancer were divided into 3 groups:colostomy group（8 cases）,washing group (9 cases) and suction group (9 cases).all the patients underwent colectomy plus stage one anastomosis and exteriorization with different interoperative preparation with which we compared the healing up of anastomosis within the three groups.results there were 3 cases having fistula in the colostomy group （8 cases）;one case in the washing group,but all the patients in the suction groups gained stage one healing up.conclusion as a method of emergency interoperative peparation,stool suction has a better healing up of anastomosis than colostomy and washing;it is advantageous to observe the healing up of anastomosis through colectomy plus stage one anastomosis and colon-outlying.

目的 探讨影响吻合口愈合因素的传统与现代观念并进一步探讨一期手术中更为合理的肠道准备方式。方法 26例降结肠癌分为造瘘组（8例）、冲洗组（9例）和粪便吸引组（9例）三组，术中分别采用3种不同方式行紧急肠道准备，所有病人均采用结肠切除一期吻合加外置的方法，对比观察三组病人的吻合口愈合情况。结果造瘘组（8例）有3例发生瘘，冲洗组有1例发生瘘，粪便吸引组全部一期愈合。结论粪便吸引作为一种术中紧急肠道准备方法，其吻合口愈合情况优于前两组；结肠一期吻合加外置的方法有利于观察吻合口的情况。

Total proctocolectomy and ileostomy is a cure for UC,total proctocolectomy and ileal pouch-anal anastomosis improves defecation control but followed by a high incidence of stomal ulcer.

全结肠切除、回肠造口术治疗较彻底，全结肠直肠切除，回肠贮袋肛管吻合术可以改善排便控制功能，是目治疗溃疡性结肠炎较好的手术方式。

The average age was 27.8 years, and there were 47.5% patients with malignant change, the average age of them was 35.9 years. The choice of operative procedures included total proctocolectomy with ileostomy in 60 cases (26.0%), subtotal colectomy+rectal polyposis electrocautery in 63 cases (27.3%), total colectomy or proetocolectomy with ileo-anal anastomosis in 12 cases (5.2%), total colectomy or proctocolertomy with ileal pouch-anal anastomosis in 19 cases (8.2%), subtotal colectomy+rectal mucoscctorny, through the muscular sheath of rectum ileo-anal anastomosis in 22 cases (9.5%), ileal pouch-anal anastomosis in 47 cases (20.3%), and subtotal proctoeoleetomy in 8 cases (3.5%).

术式选择全结肠直肠切除＋末端回肠腹壁造口术60例(26.0%)，全结肠部分直肠切除＋回肠直肠吻合术63例(27.3%)，全结肠直肠切除＋回肠肛管吻合术12例(5.2%)，全结肠直肠切除＋回肠储袋肛管吻合术19例(8.2%)，全结肠部分直肠切除＋残留直肠黏膜剥脱＋经直肠肌鞘回肠肛管吻合术22例(9.5%)，全结肠部分直肠切除＋残留直肠黏膜剥脱＋经直肠肌鞘回肠储袋肛管吻合术47例(20.3%)，部分结肠或直肠切除术8例(3.5%)。

Results Preoperative diagnostic rate was53.6%,and operative resection rate was71.4%,simple cholecystectomy in6cases,cholecystectomy and exploration of the biliary passage in4cases,gallbladder and regional lymphadonectomy in2cases,gallbladder and liver wedge resection and regional lymphadonectomy in6cases,gallblad-der and liver wedge resection and regional lymphadonectomy and right hemicolectomy in1case,and gallbladder and liver wedge resection and regional lymphadonectomy and subtotal gastrectomy and right hemicolectomy in1case.Unre-sectable rate were28.6%,gastro-jejunostomy in2cases,cholecystostomy in1case.Laparotomy exploration only in5cases.

结果 术前确诊率仅为53.6%（15/28），手术切除率为71.4%（20/28），单纯胆囊切除术6例（占21.4%），胆囊切除+总胆管探查4例（占14.3%），胆囊切除+区域淋巴结清扫2例（占7.1%），胆囊+肝楔状切除+区域淋巴结清扫6例（占21.4%），胆囊+肝楔状切除+区域淋巴结清扫+右半结肠切除1例（占3.6%），胆囊+肝楔状切除+区域淋巴结清扫+胃大部切除+右半结肠切除1例（占3.6%），未切除率为28.6%，胃-空肠吻合术2例（占7.1%），胆囊造瘘1例（占3.6%），仅做剖腹探查术5例（占17.9%）。

Results In group A, 5 cases underwent elective colectomy. Half year after operation, 3 cases with normal defecation, 2 with constipations relapse. In group B, 8 cases underwent subtotal colectomy and partial rectectomy with cecorectal anastomosis. One with constipations relapse, other patients had 37 times of defecation per day after half year of operation.

结果 A组：采用选择性结肠肠段切除术治疗5例，术后半年内随访，3例大便正常，但有2例便秘复发。B组：采用结肠次全切除和部分直肠切除，行盲直肠吻合术治疗8例，有1例术后半年内便秘复发，其他患者术后半年内排便次数为3～7次/d。

Only hydroperoxides decreased significantlyat the end of surgery for the open sigmoidectomy with propofolanesthesia and laparoscopic sigmoidectomy with propofol anesthesia,by 120 ± 73 and 144 ± 107 UCarr (1 UCarr correspondsto 0.8 mg/L H2O2), respectively.

异丙酚麻醉开腹和腹腔镜乙结肠切除术中过氧化氢显著减少，减幅分别为120 ± 73和144 ± 107 Ucarr （1 Ucarr 对应0.8 mg/L H2O2。

Results All fifty-four adenomata were excised with electrotomy.The adenomata distributed mainly over left-side colon（47/54）.Bleeding occurred in five patients during the operation（5/26）.None had delayed bleeding and perforation after endo-scopic therapy.

结果 54颗腺瘤全部采用电切除术切除，腺瘤主要分布在左半结肠（47/54），术中出血5例（5/26），全部患者无术后迟发性出血、腹痛和穿孔发生。

Total proctocolectomy and ileostomy is a cure for UC,total proctocolectomy and ileal pouch-anal anastomosis improves defecation control but followed by a high incidence of stomal ulcer.

全结肠切除、回肠造口术治疗较彻底，全结肠直肠切除，回肠贮袋肛管吻合术可以改善排便控制功能，是目前治疗溃疡性结肠炎较好的手术方式。

We tested the hypothesisthat supplemental fluid administration during and after electivecolon resections decreases the incidence of postoperative woundinfections.

我们测试了下述假设，择期结肠切除术手术时和手术后补足液体可减少术后伤口感染的发生率。

Adhering band between the sigmoid colon and the left gluteus maximus is the outset in the lateral dissection in the left coloectomy.

乙状结肠和左侧腰大肌筋膜之间的粘连带是左半结肠切除术外侧分离的起点。

And Pharaoh spoke to Joseph, saying, Your father and your brothers have come to you.

47：5 法老对约瑟说，你父亲和你弟兄们到你这里来了。

Additionally, the approximate flattening of surface strip using lines linking midpoints on perpendicular lines between geodesic curves and the unconditional extreme value method are discussed.

提出了用测地线方程、曲面上两点间短程线来计算膜结构曲面测地线的方法，同时，采用测地线间垂线的中点连线和用无约束极值法进行空间条状曲面近似展开的分析。