SU933087A1

SU933087A1 - Method of forming ejujnostoma

Info

Publication number: SU933087A1
Application number: SU802993886A
Authority: SU
Inventors: Борис Иванович Марфин; Ирина Григорьевна Бачурина
Original assignee: Воронежский государственный медицинский институт им.Н.Н.Бурденко
Priority date: 1980-10-20
Filing date: 1980-10-20
Publication date: 1982-06-07

Description

(5) СПОСОБ ФОРМИРОВАНИЯ ЕЮНОСТОМЫ(5) METHOD OF FORMING JUNOSOME

1one

Изобретение относитс к медицине, :а именно к хир,ур,гии органов брюшной полости.This invention relates to medicine, namely, hir, ur, the organs of the abdominal cavity.

Известен спрсоб формировани еюностомы , кртфый осуществл етс путем пересечени тощей кишки ниже св зки Трейца, наложени анастомоза между центральным и аборальным концом тощей кишки на передней брюшной стенке Ij.Known is the formation of eunostoma, which is carried out by crossing the jejunum below the Treitz ligament, and placing an anastomosis between the central and aboral end of the jejunum on the anterior abdominal wall Ij.

Однако известный способ не исключает забрасывани кишечного содержимого из аборального конца тощей кишки на кожу, вызыва мацерацию кожи и выраженные болевые ощущени .However, the known method does not exclude throwing intestinal contents from the aboral end of the jejunum onto the skin, causing maceration of the skin and pronounced pain.

Целью изобретени вл етс исключение забрасывани кишечного содержимого из аборального конца тощей кишки на кожу.The aim of the invention is to eliminate the throwing of intestinal contents from the aboral end of the jejunum onto the skin.

Поставленна цель достигаетс тем, что при осуществлении способа формировани еюностомы путем пересечени тощей кишки ниже св зки Т(эейца, наложени анастомоза между центральным и аборальным концом тощей кишки сThe goal is achieved by the fact that when implementing the method of forming a jejunostomy by intersecting the jejunum below the ligament T (Eijets, the imposition of the anastomosis between the central and aboral ends of the jejunum with

последующей фиксацией аборального конца выведенного на переднюю брюшную стенку, после наложени анастомоза на аборальный конец тощей кишки накладывают два кисетных шва,-отступа от кра кишки, затем свободный край аборального конца тощей кишки погружают внутрь просвета кишки и зат гивают ее кисетным швом.after fixing the aboral end of the anterior abdominal wall, after placing the anastomosis on the aboral end of the jejunum, two purse-string sutures are inserted, a spike from the edge of the intestine, then the free edge of the aboral end of the jejunum is dipped inside the intestinal lumen and tightened with a purse-string suture.

Способ осуществл ют следующим об10 разом.The method is carried out as follows.

Claims

The jejunum is crossed transversely 30 cm below the Treitz ligament and the central end is anastomotic with a distal one, indented 20 cm downward from the point of end to side. The free end of the intestine with two successive silk purse-string sutures 1.5 cm from the end and one from the other is dipped inward and tied on a rubber probe inserted into the intestine. This creates a kind of non-spill inkwell. Through a small incision in the left hypogastrium, the probe is brought out, and the intestine is fixed to the parietal peritoneum. A lip-shaped fistula is formed. Example. Ill S., 53, was admitted with a diagnosis of gastric cancer stage 1I. Complaints of vomiting after each meal. Sick exhausted. Made operation. Upper mid-incision open abdominal cavity. There is a moderate amount of serous effusion. The entire stomach of the tumor process is sealed, shrunk. The tumor process spreads to the retroperitoneal space. Radical surgery is not possible. It was decided to perform an enterostomy for feeding the patient. At 30 cm below the link of the Treyz, the jejunum is crossed and the central end is anastomosed with the distal one, indent from the intersection point 20 cm downwards in the end-to-side type. The free end of the intestine is two 1.5 cm long silk purl sutures, 1.5 cm from the end, and one from the other is immersed inward and is tied to the zoo. Through a small incision of the anterior abdominal wall in the left hypogastrium, the probe is brought out, and the intestine is fixed to the pariental peritoneum. The middle of the wound is sutured tightly. Healing by primary tension. Through the stoma, from the 5th day after the operation, the patient was started feeding the liquid and crushed nutrient mixture once a day. After removing the probe, the contents were not cast. The patient lived 3 months after the operation. During this time, feeding was carried out through a probe. She died from cancer intoxication. Operations described method was performed three times. In all cases after the bowel engraftment, the feeding tube was inserted and removed freely. After removing the probe, the stoma always remained dry. The skin around the groans was not damaged. The use of the method leads to the complete cessation of the throwing of intestinal contents from the aboral end of the intestine onto the skin, excluding maceration of the skin and pain. The invention of the method of forming an eunostoma by intersecting the jejunum below the Treitz ligament, imposing an anastomosis between the central and aboral end of the jejunum, followed by fixation of the aboral end deduced to the anterior abdominal wall, which is of a kind and in order to eliminate the intestinal contents From the aboral end of the jejunum to the skin, after the anastomosis is applied, two pouch sutures are put on the aboral end of the jejunum, a distance from the edge of the intestine, then the free edge of the aboral end of the jejunum ki immersed inside the intestinal lumen and z.at bend it with a purse-string suture. Sources of information taken into account during the examination 1. G. Ostroverkhov. and others. The course of operative surgery and topographic anatomy. M., Medicine, 196, p. 602 (prototype).