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Early Effect Following the Resection of IlealCecum and Right HemicolonAn Experimental Study

Objective To explore the early effect following resection of ilealcecum and right hemicolon. MethodsTwenty piglets were randomly divided into 2 groups, 10 in control group and experimental group respectively. The ilealcecum and right hemicolon for 50 cm each were resected in the experimental group. The two groups were fed the same food before and after the operation. Some indexes of two groups were monitored. Results①In the two groups, the body length change wasn’t significant (Pgt;0.05); but the body weight had descended markly in experimental group, compared with control group, since 3 weeks after operation (Plt;0.05). ②In experimental group, the ileal bacteria were increased from 104-107/ml before operation to 109-1011/ml at 6 weeks after operation (Plt;0.05). ③The enterohepatic circulation of biliac acid was affected during the early phase after resection. ④In experimental group, the stool became diluted within 6 weeks after operation. ⑤In the two groups, the Vitamin B12 was waved slightly within 6 weeks after operation (Pgt;0.05). The megaloblastic anemia was not appeared. ⑥The function of liver and the absorption of Na+, Cl-,K+ did not change significantly (Pgt;0.05). Conclusion The ileocecum and right hemicolon are very important for digestion and absorption, it should be retained or the ileocecal valve should be reconstructed if possible.

回盲部炎性假瘤12例报告

回盲部结肠癌误诊为阑尾炎30例分析

【摘要】　目的　分析回盲部结肠癌误诊为阑尾炎的原因及如何避免误诊的方法。　方法　回顾性分析1998年1月－2010年10月误诊为阑尾炎的回盲部结肠癌患者30例的临床资料。其中男24例，女6例；年龄14～78岁，平均56岁。30例患者均行手术治疗，阑尾切除术中发现回盲部结肠癌28例而改行其他术式，其中一期右半结肠癌根治术12例，姑息性右半结肠切除术5例，回肠横结肠短路术6例，二期手术5例；1例于阑尾切除术后15 d发现回盲部结肠癌，行右半结肠癌根治术；1例于阑尾切除术后6个月因肠梗阻明确诊断而再次手术，行右半结肠癌根治术。20例术后行全身静脉联合化学疗法治疗。　结果　术后发生切口感染6例，经局部换药、抗感染及支持等治疗后切口丙级愈合；其余切口均甲级愈合。术后无肠漏发生。住院时间12～68 d，平均18 d，住院期间无死亡者。所有患者术后病理检查均证实为回盲部结肠腺癌，其中合并阑尾炎28例。20例获随访，随访时间3个月～12年，平均5.6年。6例因无法切除病灶而行回肠横结肠吻合短路手术，于术后6～15个月死亡；5例行姑息性右半结肠切除术，于术后9～27个月死亡；余9例随访2～12年无复发。同期收治回盲部结肠癌167例，误诊、漏诊率为18%。　结论　回盲部结肠癌有时易误诊为阑尾炎，或并发阑尾炎时易漏诊；应仔细询问病史，全面了解和掌握患者的病情，完善必要的辅助检查，不要盲目自信是防止误诊、漏诊的关键。

创伤性腹股沟疝囊内回盲部破裂的手术方法选择（附 3 例报道）

目的 总结创伤性腹股沟疝囊内回盲部肠管破裂的治疗经验以供临床参考。 方法 回顾性分析笔者所在医院于 2000 年 1 月至 2016 年 12 月期间收治的 3 例创伤性腹股沟疝囊内回盲部肠管破裂患者的临床资料。 结果 3 例患者均为男性，其中 1 例右腹股沟滑动性疝患者行回盲部切除、回肠升结肠端侧吻合术；1 例右腹股沟斜疝患者行回肠末端破裂清创吻合术，附加盲肠回肠皮管造瘘以保留回盲瓣；1 例右腹股沟斜疝患者行改良的经盲肠回肠皮管造瘘术。2 例避免了切除回盲部的过度医疗之嫌。术后 3 例患者均一期治愈，无吻合口漏、修补口瘘、腹腔脓肿形成、切口感染等并发症发生。术后 3 例患者均获随访，随访时间 2～3 年，随访期间无一例疝复发。 结论 对创伤性腹股沟疝囊内回盲部肠管破裂患者，需根据损伤部位及损伤程度施行不同的手术。