非结肠准备结肠癌性梗阻Ⅰ期切除46例临床研究

CLINICAL RESEARCH ON 46 CASES OF NON-COLONIC PREPARATION FIRST-STAGE EXCISION OF COLON CANCEROUS OBSTRUCTION

目的:回顾性总结10年间46例非结肠准备结肠癌性梗阻Ⅰ期切除的临床研究。方法:术前未行肠道准备,在术中均采用徒手排空肠道内容物,保证远端肠管通畅后消毒吻合口进行结肠端端吻合。结肠次全切除、回肠乙状结肠吻合术5例;左半结肠切除、横结肠乙状结肠吻合术32例;乙状结肠及部分直肠切除、降结肠直肠吻合术9例(Dixonsy术6例,改良welch术3例)。结果:吻合Ⅰ期愈合45例(97.82%),切口感染2例(4%),吻合口漏1例(2%),死亡2例(4%);平均住院22.8天。结论:积极作好术中肠道排空处理,掌握好吻合条件及技术保证,结肠癌性梗阻Ⅰ期手术在临床上是可行的并获得良好效果。

Objective： To summarize retrospectively 46 cases of non- colonic preparation first-stage excision of colon cancerous obstruction.Methods： 46 cases without colonic preparation were studied.During operation,intestinal content was evacuated with hands and ensured that the distal intestine was unobstructed. After disinfecting, colon anastomosis was performed： 5 cases of colon inferior total excision, ileum and sigmoideum anastomosis; 32 cases of left half colon excision, transversum and sigmoideum anastomosis; 9 cases of sigmoideum and partial rectum excision, the descending colon and rectum anastomosis （dixonsy method 6 cases, improving welch method 3 cases）.Restllts： There were 45 cases of first-stage coalescence （97.82%）;2 cases of cut infection （4%）; 1 case of anastomatic leakage （2%）; 2 cases of death （4%）.The average hospitalized time is 22.8 days. Conclusion：It is observed that the first-stage surgery of colon cancerous obstruction is feasible and effective on condition that intraoperative intestinal evacuating processing is correct and active, as well as the condition of anastomosis and the technology guarantee is accurately provided.