结直肠癌并肠梗阻一期切除吻合器吻合效果分析

Radical resection and primary anastomosis by using stapler for colorectal cancer associated with intestinal obstruction

目的探讨结直肠癌并肠梗阻一期切除吻合器吻合临床疗效。方法 2005年1月至2011年6月间收治结直肠癌并肠梗阻患者72例,行肿瘤根治性切除,吻合器一期切除吻合。结果 72例患者中右半结肠癌28例,左半结肠癌24例,直肠癌20例,均一期切除吻合成功,未发生吻合口漏。治愈68例(94.4%),围手术期死亡4例(5.6%),术后发生严重并发症12例(16.7%)。68例患者均获随访,随访时间0.5～5年,病死率55.9%(38/68);1、3、5年生存率分别为:91.2%(62/68)、73.5%(50/68)和44.1%(30/68)。结论结肠癌并肠梗阻行肿瘤根治性切除,吻合器一期切除吻合安全、可靠、省时,是提高吻合成功率,减少吻合口漏的方法之一。

Objective To investigate the effect of radical resection and primary anastomosis using a stapler for colorectal cancer associated with intestinal obstruction. Methods Clinical data of 72 patients with colorectal cancer associated with intestinal obstruction who had been treated between January 2005 and June 2011 were analyzed retrospectively. All the patients received radical resection and primary anastomosis using a stapler. Results In the 72 patients 28 patients had right colon cancer,24 patients had left colon cancer,and 20 patients had rectum cancer,and none suffered from anastomotic leakage. Of the 72 patients,68 （ 94. 4% ） were cured,and 4 （ 5. 6% ） died. Twelve patients （ 16. 7%） had severe complications after operation. 68 patients were followed up for 0. 5 to 5 years. The mortality of the patients was 55. 9% （ 38 /68） ,and the 1 - ,3 - ,5 - year survival rates for the patients were 91. 2% （ 62 /68） ,73. 5% （ 50 /68） ,44. 1% （ 30 /68） respectively. Conclusions Radical resection and primary anastomosis using a stapler are a safe,reliable and effective method,which could increase the success rate of the operation, and reduce the anastomotic leakage of patients with colorectal cancer associated with intestinal obstruction.