October 1956

Behavior and Fate of Ileal Segments Interposed in the Left Colon

Author Affiliations

Atlanta; Columbus, Ohio
Department of Surgery and the Surgical Laboratories, Ohio State University Health Center. John and Mary Markle Fellow in Medical Science (Dr. Watman). Present address: Department of Surgery, Emory University Medical School (Dr. Thompson).

AMA Arch Surg. 1956;73(4):645-653. doi:10.1001/archsurg.1956.01280040101012

Segments of small bowel have been used in a variety of ways by surgeons and experimentalists as substitute and repair structures.1 Several investigators have utilized ileum to replace resected segments of the left colon both in experimental animals and, more recently, in humans.* Consideration of the problems of colon surgery and, more specifically, of surgery of malignant lesions of the left colon suggest that the use of ileal grafts might find clinical application. Current concepts of adequate cancer surgery include high vascular ligation and wide mesenteric resection. There are situations when adherence to these concepts necessitates the formation of a permanent colostomy even though the location of the lesion justifies resection with primary anastomosis. This situation may exist when mobilization of the hepatic flexture is impractical or excessively difficult or, as pointed out recently by Baker,9 when anomalies of the middle colic vessels make mobilization of the promimal

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