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Initial Experience Using an Extraperitoneal Approach to Close a Temporary End Ileostomy in Patients with Severe Intestinal Adhesion: Report of Two Cases

經由腹膜外閉合暫時性迴腸造廔之初步經驗:對於兩例嚴重腸粘連病人之病例報告

Abstracts


對於一些因腹部急症實施迴腸造廔術後引起嚴重腸粘連之病人,在日後實行腹膜內迴腸結腸造廔閉合術時,常因實行腸壁分離術困難,不僅耗時,且常醫源性弄破腸壁,而引起術後許多併發症。作者初次嘗試從右側剝離腹壁腹膜,於腹膜外找到結腸擊帶,做迴腸結腸吻合術,閉合兩例因嚴重腸粘連,而於腹膜內分離腸壁困難之病人的迴腸造廔。此方法不僅可以縮短手術時間,而且減低了醫源性腸壁破裂的可能。在術後追蹤六、七個月尚未發現如感染、阻塞、滲漏或廔管之併發症。

Parallel abstracts


We discuss the closure of a temporary end ileostomy via an extraperitoneal approach in two patients who had had previous surgery due to peritonitis. They suffered from severe intestinal adhesions which made intraabdominal enterolysis a difficult prospect. An extraperitoneal end to side anastomosis of the ilium and ascending colon was performed a few months after the initial operation. This method not only shortened operating time, but also avoided the possibility of iatrogenic intestinal perforation. Frequently ocurring post-operative complications such as infection, obstruction and fistula were not found in the six and seven month follow up periods, respectively.

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