梗阻性结直肠癌169例临床诊治分析

Retrospective analysis of diagnosis and therapy in 169 patients with obstructive colorectal cancer

目的探讨梗阻性结直肠癌的诊治原则和手术方式。方法回顾性分析1996年5月-2007年5月收治的169例梗阻性结直肠癌病例。结果169例中，术前明确梗阻部位者152例，Ⅰ期切除吻合术144例，肿瘤切除、近端结肠造口术21例，肿瘤近端结肠造口术4例。肿瘤切除率97．6％，Ⅰ期切除吻合术占85．2％。切口感染25例，切口裂开15例，肠瘘3例，围手术期死亡5例。结论梗阻性结直肠癌术前应尽量明确梗阻部位，结合患者的全身情况、腹腔污染和肿瘤周围侵犯情况选择合理的术式，加强围手术期的处理是保证Ⅰ期结肠肿瘤切除吻合术成功的关键。

Objective To evaluate diagnosis -therapy principle and modus operation of obstructive colorectal cancer. Methods 169 obstructive colorectal cancer cases from may 1996 to may 2007 were analysised retrospective. Results 152 cases were identified where happened obstruction preoperative, Ⅰ stage resect and storey were 144 cases,tumor resect and proximal colostomy were 21 cases,proximal colostomy were 4 cases, Tumor resect rate was 97. 6 %, Ⅰ stage resect and storey rate was 85, 2 Ⅰ. infection of incisional wound were 25 cases,disruption of wound were 15 cases,intestinal fistula were 3 cases,5 cases were died preoperative, Conclusion Before operation,we should identify obstructive location and choose reasonable operative method according to patients general condition,cavum abdominals pollution and tomors periphery encroachment, preoperative treatment is the criticality of Ⅰ stage resect and stomy.