本院大腸直腸外科自行設計一種新式的腸內保護管,是結合可分解式腸道吻合環與保險套的長而軟的保護內管。從民國88年1月至93年10月,共計有四例左側大腸阻塞病人配合腸內保護管的使用,接受此種壹階段切除並吻合的緊急手術。術中先沖洗移除腸內糞便,再成功的施行此壹階段手術,並沒有吻合不全引起嚴重併發症。術後追蹤,腸內保護管因為吻合環的可分解特性,均於手術後三週左右自行分離成碎片而由肛門隨糞便排出,並沒有吻合洩漏併發症,亦無死亡病例。我們初期經驗認為在左側大腸阻塞緊急手術時,使用此一腸內保護管的技術,能夠很安全的操作此壹階段手術來保護直腸吻合,不需加做人工肛門。
Objective: To determine the efficacy of a new intracolonic bypass tube (ICBT) designed for a one-stage procedure for left colonic obstruction. Methods: This new ICBT is our self-designed device, called the Valtrac®-secured intracolonic bypass tube. We applied this device under the emergent condition of left colon obstruction, and investigated its effectiveness and safety. Results: In all four patients who underwent intracolonic bypass, the obstruction was relieved, the tube was spontaneously expelled, and there was no post-operative morbidity or mortality. Conclusion: The Valtrac®-secured ICBT provides an alternative safe one-stage procedure for emergent procedures involving the left colon.
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