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| 1 | Integrated approach to colorectal anastomotic leakage: Communication, infection and healing disturbances显示文摘Colorectal anastomotic leakage(CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the available strategies regarding prevention, prediction and intervention of CAL and categorize them into three categories: communication, infection and healing disturbances. These three major factors actively interact during the onset of CAL. We aim to provide an integrated approach to CAL based on its etiology. The intraoperative air leak test, intraoperative endoscopy, radiological examinations and stoma construction mainly aim to detect and to prevent communication between the intra- and extra-luminal content. Other strategies including postoperative drainage, antibiotics, and infectious-parameter evaluation are intended to detect and prevent anastomotic or peritoneal infection. Most currently available interventions for CAL focus on the control of communication and infection, while strategies targeting the healing disturbances such as lifestyle changes, oxygen therapy and evaluation of metabolic biomarkers still lack wide clinical application. This simplified categorization may contribute to an integrated understanding of CAL. We strongly believe that this integrated approach should be taken into consideration during clinical practice. An integrated approach to CAL could contribute to a better understanding of the etiology of CAL and eventually better patient outcome. | Cloe L Sparreboom Zhou-Qiao Wu Jia-Fu Ji Johan F Lange | 2016 | World Journal of Gastroenterology2016，22，32： | 9 |
| 2 | 肠管局部切开不同缝合方式的对比研究显示文摘目的本课题通过建立动物模型,观察不同缝合方式对肠管愈合的影响,探讨两种不同缝合方式的优劣,以进一步寻找更好的缝合方式,为手术提供更好的选择。方法一期手术分别建立纵切横缝及纵切纵缝的动物模型,然后二期手术获取瘢痕标本。分别通过观察缝合处炎症粘连情况、记录瘢痕评分、肠管的容积、肠管内径以及不同缝合方式的瘢痕的病理表现,从而选择出更好更加美容的缝合方式。结果纵向缝合与横向缝合相比,纵向缝合所需的缝合时间较短;瘢痕评分较低;纵向缝合肠管内周径较短。横向缝合与纵向缝合相比,二者在肠管容积和肠管局部粘连方面无明显差异。从病理上来看,纵向缝合的黏膜下层产生了大量的成纤维组织,排列尚为整齐。横向缝合黏膜下层大量的成纤维组织增生,增厚,排列紊乱,大量片状炎症细胞浸润,肌层轻度水肿。结论纵向缝合是一种快捷,有效的的缝合方法。在相同的缝合线下,纵向缝合可减轻因手术创伤而引起的炎症反应,降低了术后瘢痕增生的程度;纵向缝合更加符合解剖结构,使组织相容性更好。 | 苗大壮 王贵玉 姜争 刘正 马天翼 王锡山 | 2014 | 中华结直肠疾病电子杂志2014，3，6： | 1 |
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