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- W2333411988 abstract "高齢者急性上腸間膜動脈 (SMA) 閉塞症, 小腸壊死に対する広範囲小腸切除後に, 1期的吻合を行ったので, その有用性と安全性を検討した. 83, 78, 75歳の女性の急性SMA閉塞症3例に広範囲小腸切除を行った. 小腸壊死と血性腹水を認めたが, 腸管穿孔はなかった. 数cmの小腸温存には固執せず, 確実に安全と思われる部位で切離し, 器械吻合で1期的に再建した (側端, 側端, 端側吻合). 残存小腸は, Treitz靭帯から30cm, 幽門輪から50cm, Treitz靭帯から30cm, 経口摂取は, 各16, 17, 10病日から開始した. 経口摂取後の排便回数は, 各3～4, 0～1, 15回前後/日と端側吻合で頻回の傾向にあった. 維持輸液も各2,000ml, 1,000, 2,000～1,000ml/日前後であった. 全例, 縫合不全や残存腸管の虚血の進展の徴候はなかった. 高齢であることから消化吸収能をある程度犠牲にして, 空腸瘻とせず一期的に吻合を行ったことで, 近位空腸瘻のデメリットを回避した. 術後造影検査での造影剤の移動速度から, 側端吻合が消化, 吸収に有用と思われた." @default.
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- W2333411988 date "1999-01-01" @default.
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- W2333411988 title "Usefulness and Safety of Simultaneous Anastomosis at Bowel Resection for Acute Mesenteric Arterial Occlusion in Elderly Patients." @default.
- W2333411988 doi "https://doi.org/10.5833/jjgs.32.2158" @default.
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