大肠癌致肠梗阻的外科诊治

Surgical treatment of large bowel obstruction caused by colorectal carcinoma

目的探讨大肠癌致肠梗阻的外科诊治方法。方法分析我院1996年至2006年间46例大肠癌致肠梗阻的外科诊治资料。结果 46例患者中行右半结肠一期切除吻合17例,横结肠癌切除一期吻合3例,行左半结肠一期切除吻合18例,行左半结肠及直肠上段癌切除近段结肠造口,关闭远段结肠或直肠备二期吻合4例,另有4例乙、直肠癌无法切除仅行造口术。吻合口漏2例(4.3%).围手术期死亡1例(2.1%)。结论重视大肠癌致肠梗阻的早期诊断,合理选择手术方式;做好围手术期处理是减少并发症及死亡率,提高疗效的重要措施。

Objective To study the surgical treatment of large bowel obstruction caused by colorectal carcinoma. Methods Retrospective analysis of the experience of surgical treatment of the large bowel obstruction caused by colorectal carcinoma in 46 patients from 1996 to 2006 was performed. Results In the 46 patients, the right hemicolectomy and anastomosis were performed in 17 patients, the transvercolectomy and anastomosis were performed in 3 patients, and the left hemicolectomy and anastomosis were performed in 18 patients;4 patients were subjected to the Hartmann operation, and sigmoidostomy was performed in 2 patients for thdr rectum carcinoma couldn＇t be resected. Anastomotic leakage occurred postoperatively in 2 patients （4.3 % ）, and one case was dead perioperatively （2.1% ）. Conclusion More attention should be paid to large bowel obstruction caused by colorectal carcinoma. Selecting rational colectomy and appropriate perioperative management is important for reducting both complications and mortality rate.