重度の便秘で直腸の排泄のために大陸大腸管
N S Williams1, S F Hughes, B Stuchfield
1Surgical Unit, Royal London Hospital, Whitechapel, UK.
Lancet (London, England)
|May 28, 1994
まとめ
大陸結腸管を使用した新しい外科技術により,直腸排泄障害の患者の70%で腸の排泄が改善されました. この処置は,難易度の高い腸疾患の管理に役立つ,よりシンプルな代替手段です.
科学分野:
- 結腸直腸外科手術について
- 胃腸内科 胃腸内科
- 外科技術革新 (Chirurgical Innovation) について
背景:
- 排泄器直腸障害は,患者の管理に重大な課題をもたらす.
- 保守的な措置は,これらの条件に対してしばしば無効である.
- 治療結果を改善するために,新しい外科的アプローチが必要である.
研究 の 目的:
- 直腸排気管障害の治療のための新しい外科的処置を導入し,評価する.
- 大陸大腸管の有効性と安全性を評価するために,入腸弁が置かれている.
主な方法:
- 10人の患者のシグモイド結腸から大陸結腸管を手術で作りました.
- 管道には,灌と避難を容易にするため,インツスサスペクトバルブが組み込まれていました.
- 患者のアウトカムは,避難時間,不快感,便の頻度,および合併症に基づいて評価されました.
主要な成果:
- 10人の患者全員が当初,避難時間が短縮され,不快感が感じられたと報告した.
- 便の頻度は,手術後の90%の患者で有意に増加しました (平均1.5〜7便/週).
- 30%の患者に合併症が発生し,2人の患者にイレオストミー治療が必要となった.
結論:
- 大陸結腸管の手術は,直腸排泄器の障害を持つ選択された患者にとって実行可能な外科的選択肢です.
- このテクニックは,ほとんどの患者の腸機能を改善する最初の成功を示しました.
- 潜在的な合併症のために,慎重に患者の選択とモニタリングを行うことが不可欠です.
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