左半结肠癌并急性肠梗阻的手术治疗体会(附53例报告)

Surgical treatment of left colon cancer complicated by acute intestinal obstruction(A report of 53 cases)

目的探讨左半结肠癌并发急性肠梗阻的手术处理方法。方法回顾性分析我院2001年1月～2007年1月收治的左半结肠癌并急性肠梗阻53例的临床资料。结果本组病例术后无一例出现吻合口瘘,其中(1)行一期切除、吻合术34例;(2)行肿瘤切除、结肠远端封闭、近端造瘘术16例;(3)肿瘤未能切除,行结肠造瘘术3例;发生切口感染6例;术后死亡4例(7日内)。结论对左半结肠癌并发急性肠梗阻的病人应根据具体病情选择术式,术中充分的结肠灌洗、减压、完善围手术期治疗,一期切除吻合术是安全可行的,可提高患者的生活质量,避免二次手术的痛苦。

Objective To study the surgical treatment of left colon cancer complicated by acute intestinal obstruction. Methods From January 2001 to January 2007, the clinical data of 53 cases with left colon cancer complicated by acute intestinal obstruction were analyzed retrospectively. Results One-stage colectomy and anastomosis were performed in 34 cases, colectomy and colostomy in 16 cases, and palliative colostomy in 3 cases. No anastomic leakage was found after operation. Infection of incisional wound happened in 6 cases, and 4 patients died. Conclusion According to the patients＇ status, different operative manner was chosen. Enough Colon lavage, decompression during operation and perfect perioperative management are safe and effective for left colon cancer complicated by acute intestinal obstruction. One-stage operation can improve quality of life and avoid second-stage operation.