低位大肠癌并梗阻的临床特点及一期切除体会(附102例分析)

Clinical features of the low large intestinal cancer associated with obstruction and experience of one-stage resection (An analysis of 102 cases)

目的探讨低位大肠癌并梗阻的临床特点及一期切除术的体会。方法回顾性分析我院1997年6月～2004年12月间102例低位大肠癌并梗阻的临床资料。结果本组除16例行结肠造瘘术外,其余86例均为一期切除吻合术,其中根治切除64例,姑息切除22例。术后并发腹腔脓肿8例、切口感染13例,无一例发生吻合口瘘。随访78例,无一例术后1年内死亡。结论低位大肠癌并梗阻以老年多见、伴发病较多、多属晚期、常伴有水电解质、酸碱平衡紊乱等特点。掌握好适应证和术中结肠灌洗技术,一期肿瘤切除安全可行、效果好。

Objective To investigate the clinical features of the low large intestinal cancer associated with obstruction and experience of one-stage resection. Methods From June1997 to December 2004,the clinical data of 102 cases with low large intestinal cancer associated with obstruction were analyzed retrospectively. Results Except that 16 cases underwent colostomy,the other 86 cases underwent one-stage resection and anastomosis. Among them, 64 cases underwent radical resection and 22 cases underwent palliative resection. Postoperative intra-abdominal abscess was happened in 8 cases, infection of incisional wound was 13 cases. No anastomotic fistula was found. Follow-up was gotten in 78 cases after operation. There was no one death within one year after operation. Conclusion The features of the low large intestinal cancer associated with obstruction are as follows： It usually occurs in aged, with more complications, most of belonging to advanced stage and water-electrolyte imbalance and acid-base disturbance are often seen.If operation indication and intraoperative colonic lavage can be grasped well,one-stage resection and anastomosis possesses safe and effective.