结肠切除术

Objective To evaluate the application value and prognosis of three-ring ileo-pouch anal anastomosis with selected blocking after total colectomy.

e# 目的探讨全结肠切除后三环型回肠贮袋肛管吻合加选择性截流术的价值和疗效。

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.

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。

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.

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。

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.

目的 探讨影响吻合口愈合因素的传统与现代观念并进步探讨一期手术中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 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。

Methods:clinical data of 23 cases of left-sided colonic carcinoma undergoing one-stage resection and primary anastomosis were analyzed respectively.intraoperative colonic lavage were performed in all cases.for the 14 cases which were considered to be dangerous,preventive ceostomy was performed.results:23 cases were performed one-stage resection and primary anastomosis,all patients had not any complications such as anastomatic leakage and infection of the peritoneal cavity.conclusions:have a strict control over operation indication,perform postoperative care properly, one-stage resection and primary anastomosis for acute obstruction of left hemicolonic carcinoma is safe and workable.

回顾性分析我院五年来23例左半结肠癌并急性梗阻一期切除吻合术的临床资料，所有病例均术中结肠灌洗，而认为有危险性的14例同时行预防性盲肠造瘘。结果：23例一期切除吻合术，无一例发生吻合口漏、腹腔感染等并发症。结论：严格掌握手术适应症，积极术前准备，充分结肠灌洗，对认为有危险性吻合口实行预防性盲肠造瘘，正确术后处理，左半结肠癌并急性梗阻一期切除吻合术是安全可行的。

Period,12 cases defecated normally,18 cases undergoing internal sphincter myomectomy and 30 cases undergoing radical excision had good restoration.

结果 均顺利渡过最初危险期，其中12例排便恢复正常；18例行内括约肌部分切除术；30例行巨结肠根治术，术后均恢复良好。

Results Among the 60 cases, all patients past the first riskperiod,12 cases defecated normally,18 cases undergoing internal sphincter myomectomy and 30 cases undergoing radical excision had good restoration.

结果 均顺利渡过最初危险期，其中12例排便恢复正常；18例行内括约肌部分切除术；30例行巨结肠根治术，术后均恢复良好。

To Sep. 2005. Sixteen carcinoids were extirpated by snare polypectomy under colonoscopy, and 8 carcinoids were removed by endoscopic mucosal resection.

病理确诊36例，内镜下用PSD圈套器圈除16例，热活检钳钳除3例，EMR切除8例，手术局部切除7例，直肠根治术1例，右半结肠切除1例。

Endoscopic therapy and high-frequency electroblation are effective in treatment for the huge polyps in the colon, which can be undertaken simply and safely.

内镜下尼龙绳套扎联合高频电凝电切除术治疗结肠巨大息肉的方法安全有效，并发症少。

Abstract］ objective to investigate anus sphincter preserved surgical method and indication for low rectal cancer.methods 15 cases with low rectal cancer were operated with eversion and pull-through anus preserved colorectal anastomosis through anus.results no patients died of operation,no patients was with fistula and stricture of anastomosis,no defecation incontinence happened after postoperative 20 weeks,only one patient was with local recurrence.following up for 8 months to 5 years,5 cases were with distant metastasis,4 of these died,one of these had lived with liver metastasis for 3 years.conclusion the indication of anus preserved operation should be chosen according to clinical stage and biological characteristic of rectal malignancy; eversion and pull-through anus preserved colorectal anastomosis through anus is a better anus preserved operation for low rectal cancer.

目的 探讨低位直肠癌保留肛门括约肌功能的手术方法和手术适应证。方法对低位直肠癌经腹经肛门直结肠外翻拉出保留肛门吻合术15例。结果全组无手术死亡，未发生吻合口漏和吻合口狭窄，局部复发1例，20周左右恢复正常排便排气功能，无大便失禁病例。随访8个月～5年，5例为远处转移，死亡4例，其中1例肝转移3年仍生存。结论根据直肠癌的临床分期和肿瘤的生物学特性选择保肛手术适应证，经腹、肛门齿线上直肠癌根治性切除，行肛门直结肠外翻拉出吻合是低位直肠癌较好的保肛术式。

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。