结肠次全切除治疗梗阻性乙状结肠癌16例临床分析

目的:探讨一期结肠次全切除,回肠乙状结肠或回肠直肠吻合术,治疗梗阻性乙状结肠癌的效果。方法:在收治的急性梗阻性乙状结肠癌病人中,选择行一期结肠次全切除、回肠乙状结肠或回肠直肠吻合术的16例患者的临床资料进行回顾性分析。结果:在全麻下行剖腹探查证实乙状结肠癌,行一期结肠次全切除回肠与乙状结肠吻合12例,回肠与直肠吻合4例。4例术后发生排便次数增加3～6次/d,经调节饮食和口服易蒙停等3个月治愈。切口脂肪液化感染2例,经换药处理治愈。其余均顺利康复出院,未发生吻合口瘘。结论:达到解除梗阻,根治性切除肿瘤,一期吻合重建肠道,减少吻合口瘘的发生,是治疗梗阻性乙状结肠癌安全和有效术式。

Objective: To assess the functroal results after subtotal colectomy combined with I stage anastomosis for the treatment of obstructive sigmoid carcinoma. Methods:A retrospective study of 16 patients with acute obstructive sigmoid carcinoma underwent subtotal colectomy combined I stage anastomosis from March,1995 to December,2004.Result: 12 patients underwent ileosigmoidostomy,4 patients were treated by ileorectostomy after operation,4 patients bowel frequency were 3-6 per day,through regulated food and drink,taken loperamide etc,cured 3 months later.2 patients occurrenced incision colliquation and infection were cured by changing dressings.All patients discharged rehabilitation and no patient occurrence fistula of anastomotic stoma.Conclusions:Subtotal colectomy combined with primary anastomosis for the treatment of obstructive sigmoid carcinoma can relief the obstruction and excis carcinoma,I stage anastomosis can reduce fistula of anastomotic stoma.So subtotal colectomy is effective and security method for managemenet of obstructive sigmoid carcinoma.