cecal fistula

Cecal ostomy is a temporary partial ostomy. Applicable to 1. Complete simple obstruction of the colon, the disease is not allowed to cure, can be used for cecal fistula, but the bowel movement is not as complete as colostomy. Therefore, it is mostly used for temporary decompression, and then undergoes radical surgery after the condition is improved. 2. Colonic anastomosis (or repair) before or after surgery, decompression is needed to ensure the healing of the anastomosis. Treatment of diseases: intestinal obstruction Indication 1. Complete simple obstruction of the colon, the disease is not allowed to cure, can be used for cecal fistula, but defecation is not as complete as colostomy. Therefore, it is mostly used for temporary decompression, and then undergoes radical surgery after the condition is improved. 2. Colonic anastomosis (or repair) before or after surgery, decompression is needed to ensure the healing of the anastomosis. Contraindications The age of the body is weak, the vital organs such as the heart and lungs are poor, and the surgery does not restore hope. Preoperative preparation Before the cecal fistula operation, neomycin or streptomycin should be taken orally for 3 days, and the enema should be cleaned before the operation and on the morning of the operation. Yu Tong jejunostomy. Surgical procedure 1. Position: supine position. 2. Incision: right lower quadrant oblique incision (appendix incision), about 5cm long. 3. Excision of the appendix, placement of the fistula to expose the cecum and appendix, and the saline field gauze pad around the field. The appendix meridian was cut off, and a double-string purse was sutured around the base band of the appendix with a No. 1 silk thread. The inner ring was about 1.5 cm in diameter. Cross the appendix at the root. The stump is not ligated. The intestinal fluid is aspirated by inserting a suction device into the cecum through the stump. Immediately after the large-sized catheter is placed in the cecum [cut off the top cover], the first circle of the purse string is first tightened and ligated, and then the second loop of the purse string is ligated and the catheter is fixed. 4. Cover the greater omentum: the catheter is passed through the omentum, and the omentum is covered by the ostomy, and the colon band of the cecum wall is sutured with the peritoneum near the incision by 3 to 4 needles. 5. Stitching: The abdominal wall is sutured layer by layer, and the rubber catheter is fixed to the skin. complication Abdominal pain, wound infection.

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