高龄左半结肠癌急性梗阻一期切除42例分析

Experience of One-stage Resection of Left Colon Cancer with Obstruction in 42 Elderly Patients

目的探讨高龄左半结肠癌并急性肠梗阻手术方式与并发症的防治方法。方法回顾性分析1998年1月-2006年1月收治的42例高龄左半结肠癌并急性梗阻一期切除吻合的临床资料。结果42例中，术后发生并发症14例，发生率为33．3％（14／42），其中感染中毒性休克2例，肺部感染5例，吻合口漏2例，切口感染、裂开5例，死亡3例，死亡率为7．1％（3／42）。结论高龄左半结肠癌并急性梗阻病人术后死亡的主要原因是中毒性休克多器官功能障碍（MODS），经充分的术前准备、适当的术中处理、合理的营养支持治疗和伴发病的治疗，施行一期切除吻合是安全可行的。

Objective To study the operative procedures and prevention of complication in elderly patients with obstructive carcinoma of left colon. Methods From January 1998 to January 2006, the experience of one -stage resection for left colorectal carcinoma with obstruction in 42 patients over 60 years old was analyzed retrospectively. Results Post - operative complications oc-curred in 14（,33.3%） ,2 With toxic snock,5 with pneumonia,2 with anastomotic leakage,5 with wound dehiscence. 3 cases died （7.1%）. Conclusion Toxic shock and MODS are the main death cause of post - operative patients with left obstructive colon cancer in elderly patients. To ensure a one - stage resection safe, we should pay attention to the full pre - operative preparation,suitable operative management,reasonable post- operative nutrition and treatment of coexisting diseases.