结直肠癌急性梗阻的个体化治疗

Surgical treatment for obstruction of colorectal carcinoma

目的探讨结直肠癌急性梗阻的个体化手术治疗效果。方法1999年6月～2007年5月，本院外科共收治37例因结肠或直肠癌引起的肠梗阻，全组病例均行手术治疗，8例行Ⅰ期根治性肠切除＋吻合术；23例行根治性切除＋近断端结肠造瘘术；4例行经腹会阴切除术；2例因肿瘤无法切除，行横结肠双腔造瘘术。结果8例行肠切除Ⅰ期肠吻合者均未发生吻合口瘘，全部病例均安全度过手术关。术后病理37例均确诊为癌。结论对右半结肠癌性梗阻均可行Ⅰ期根治性右半结肠切除肠吻合术；左半结肠或直肠癌性梗阻须根据不同情况，采取个体化手术方案，才能取得满意的效果。

Objective To evaluate the effect of various surgical procedures on intestinal obstruction of patients with colorectal carcinoma. Methods From June 1999 to May 2007, a total of 37 patients with obstruction of colorectal carcinoma were enrolled. 8 cases among them underwent radical resection and anastomosis synchromously. 23 cases underwent intestinal resection and colostomy, 4 cases Miles operation. 2 cases colostomy. Results All patients recovered completely, no anastomotic leakage occured. Conclusion According to pathologic conditions of large intestine obstruction, select proper surgical procedure can avoid postoprative complication such as anastomotic leakage and improve surgical effect.