结肠癌合并不全梗阻34例外科治疗

Surgical treatment of colorectal carcinoma with obstruction uncompletely in 34 patients

目的探讨结肠癌合并不全梗阻行Ⅰ期手术切除吻合的可行性。方法回顾分析了1995至2004年收治的结肠癌合并不全梗阻行Ⅰ期手术切除吻合34例的临床资料,30例行Ⅰ期肠吻合。结果本组行Ⅰ期结肠切除吻合28例,单纯回肠横结肠吻合捷径手术2例,除1例乙状结肠切除吻合术后发生吻合口瘘经保守治愈以外,均无吻合口瘘等并发症。结论对于左半结肠癌引起的梗阻,行Ⅰ期切除吻合目前争议较大,我们认为对于梗阻时间短,梗阻程度不重,全身中毒症状较轻,肠膨胀与炎症不明显者,可以采取Ⅰ期切除吻合。

Objective To evaluate the possibility of I stage resection anastomosis in treatment of colorectal carcinoma with obstruction uncompletely. Methods Thirty-four patients received I stage resection anastomosis were analyzed. Of them, 30 received Ⅰ stage intestines coincide. Result Twenty-eight cases received Ⅰ stage colon resection anastomosis, and two cases received purely ileocolium-transvere colon anastomosis. Only one case accured anastomotic leakage after operation. The others had no complication. Conclusion If the time of obstruction is short, the degree of obstruction and the symptom of intoxication is not severe, the intestinal expantion and inflammation is not obviously, Ⅰ stage resection can be applied.