SU1126289A1 - Method of temporary enterostomy - Google Patents

Abstract

METHOD OF TEMPORARY ENTEROSTOMY. including opening, the lumen of the intestine, the introduction of an elastic tube into it, the imposition of sealing serous-muscular sutures, removal of the intestinal wall on the anterior abdominal wall, removal of the tube in the postoperative period, characterized in that, in order to shorten the healing time of the wound, at the opening of the lumen of the intestine it is serous-muscular the layer is cut transversely, with the introduction of the tube, the mucous membrane arrives to it, the nodal sutures are sealed in two rows, with ONE of the threads closest to the tube seams cerned row after binding head assembly is further carried out through the intestinal wall from inside stomicheskogo channel orients them along the axis of the intestine from both strron tube outputted g thread on perednkno brkmpnuyu wall together with the wall of intestine and their head zgoayut after removal tube.

Description

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The invention relates to medicine, in particular to surgery, and can be used for decompression and intestinal flushing. A known method for enterostomy is by applying a tubular or lip-shaped fistula 1. In most cases, the closure of such a fistula requires re-operation. There is a method of temporary enterostomy, including the opening of the intestinal lumen, the introduction of an elastic tube into it, the imposition of two sealing seromatical pouch sutures, removal of the intestinal wall to the anterior abdominal wall through a separate wound with fixation of the intestine to the C2 J peristinal peritoneum, however, the fistula of the small intestine. and tends to self-heal, still functioning for a long time after removal of the tube. The aim of the invention is to reduce the time for wound healing. The goal is achieved by the method of temporary enterostomy, which includes opening the lumen of the intestine, inserting an elastic tube into it, applying serous sealant seals, removing the intestinal wall on the anterior abdominal wall, removing the tube in the postoperative period, when opening the gut lumen of the sero-muscular layer cut transversely, with the introduction of the tube, the mucous membrane adjacent to it invades, the sealing nodal stitches strung together in two rows, with one of the threads closest to the tubes e stitches of the second row after the binding head assembly further carried out through the wall from inside the channel stomicheskogo intestine, colon landmark their axes on both sides of the tube, t vyuod thread on the anterior abdominal wall with bowel wall and head zshayut them after removal of the tube. The method is carried out as follows. Laparotomy under general anesthesia, elimination of the causes of intestinal obstruction or peritonitis. On the mesentery-free side of the intestine, selected for enterostomy (ileostomy), an incision is made in the serous-mongal membrane 1.5–2 cm long in the transverse direction relative to the length of the intestine, is applied at the corners of the wound along one seromasinus suture, not tie them in using as seam holders. The mucous membrane of the swollen loop of the intestine prolabs in the wound, it is dissected across the sarozoid of the intestine. Depending on the diameter of the tube, 1-2 additional serous-washing seams of the first row of stitches form a transverse spur, the top of which faces the intestinal lumen and formed only by duplication of the intestinal mucosa, depending on the diameter of the tube. . One thread of two serous-seam sutures adjacent to the tube is cut. The remaining thread with a needle is carried out under the sero-minor layer of the intestinal wall at a distance of 0.7-1 cm, and the needle is punctured at the level of the next second row of serous stitches (half-net or knotty), so that the needle went to the transverse with respect to the axis of the intestine tube diameter. These filaments, after stitching a second row of sutures and stitching the loop of the intestine that carries the enterostomy to the anterior peritoneum, are brought out of the adrectal wound together with the tube and are used to close the lumen of the enterostomy channel by connecting with each other — immediately after removing the tube from guts. Wound around the tube tampon. When there is a tendency to erupt the provisional suture, for example, under conditions of suppuration of the wound during peritonitis, the stitching of this suture can be delayed for more than 5 days, then a part of the enterostomy channel between the first and second rows of sutures is tamped with a subcutaneous tissue flap in Nolsk, In this case, the flap apex is kept in the canal with a provisional suture, which prevents intestinal contents from leaking into the wound until the fistula is closed from the apex of the spur. Tampnada of the external part of the enterostomy canal does not threaten with its abscess formation, since the canal cavity drains into the intestine through the apex of the spur. The cross-spur contributes to the closure of the enterostomy channel, which ensures the convergence of the channel walls even before the development of wall infiltration.

S1126289. four

intestine, which creates conditions for the delayed provisional suture to come together while the wall of the channel is not significant, only in cases of

t marry fabric. Large rum more than 0.5-0.6 cm, for example, the double contact area of its filaments from the wall of a three-channel probe, the intestine (semi-network or serous-muscular suture of the first row plus subselected tests) - a small stitch, centering or reducing the efficiency of the method, since

These provisional sutures in the middle of the external fistula stop the functioning of the Prakrr hole of the STI channel 10tily after the removal of the tube.

The formation of the enterostomy is indicated — which significantly shortens the duration of the lemma with the use of patients.

Claims (1)

METHOD OF TEMPORARY ENEROSTOMY. including opening, intestinal lumen, insertion of an elastic tube into it, application of sealing serous-muscular sutures, removal of the intestinal wall to the anterior abdominal wall, extraction of the tube in the postoperative period, characterized in that in order to reduce the healing time of the wound, opening the intestinal lumen is sero-muscular its layer is cut transversely, with the introduction of the tube, the mucous membrane adjacent to it is invaginated, the sealing nodal sutures are laid in two rows, with one of the threads of the second seams closest to the tube after tying the knot, they additionally pass through the intestinal wall from the inside of the stoma canal, orienting them along the intestine axis on both sides of the tube, bring the threads to the anterior abdominal wall together with the intestinal wall, and tie them after removing the tube. W.1126289 1 ____