梗阻性左半结肠癌一期切除吻合27例分析

Primary resection anastomosis of obstructive carcinoma of left colon analysis of 27 cases

目的对27例左半结肠癌伴急性梗阻一期切除吻合术病例资料进行回顾性分析。方法对27例左半结肠癌伴急性肠梗阻患者行一期手术切除吻合术,术中肠腔减压,结肠灌洗,掌握适应症。结果本组资料左半结肠癌合并梗阻33例行一期切除吻合术27例,切除率81.82%。术后并发切口感染4例,吻合口瘘3例,切口裂开2例。结论只要患者病情允许,严格掌握手术适应症,术中有效的肠腔减压、灌洗,对梗阻性左半结肠癌施行一期肿瘤切除吻合的手术是可行的。

Objective Primary resection and anastomosis of acute left colonic obstruction in 27 cases was analyzed. Methods Intestinal decompression and lavage was made during operation. The indications were grasped strictly. Results Of 33 patients with left colonic obstruction by tumor,27 cases underwent primary resection and anastomosis. The resective rate was 81.82 %. The complications included： infection of the operative incision occurred in 4 cases （14.8%） and postoperation anastomotic leakage found in 3 cases （ 11.1% ）, incision-breaking in 2 cases （ 7.4 % ）. Conclusion It is feasible that primary resection of carcinoma and anastomosis in the treatment of colonic carcinoma accompanied with intestinal obstruction when the patient states is allowed. Indications should be strictly grasped. Intraoperative intestinal decompression and lavage is effectively made.