结肠癌合并肠梗阻手术治疗112例

Clinical Analysis on Surgical Management for 112 Cases of Colon Cancer with Intestinal Obstruction

目的探讨结肠癌合并肠梗阻的诊断和最佳手术治疗方案。方法对1995年11月～2007年11月我们收治的112例结肠癌合并肠梗阻手术治疗的临床资料进行回顾性分析。结果 112例结肠癌合并肠梗阻中,慢性不全梗阻有89例(79.5%),急性完全性肠梗阻23例(20.5%)。112例均行手术探查,其中98例一期切除吻合术,9例切除后肠造瘘二期吻合术,5例一期近端造瘘二期切除吻合术;一期手术切除率95.5%,术后并发症12例(10.7%),死亡2例(1.8%)。结论结肠癌合并肠梗阻绝大多数为慢性不全肠梗阻。结肠癌是急性完全性结肠梗阻的主要原因。早期诊断早期手术治疗是挽救病人生命的关键。结肠切除术是解除结肠癌合并肠梗阻的主要手术方式,理想的手术方式是Ⅰ期根治切除吻合术,有效的结肠灌洗可提高工期根治切除手术率。

Objective To investigate the diagnosis and best surgical operation project on colon cancer with intestinal obstruction. Methyls Retrospectively analysis on the 112 cases with colon cancer with intestinal obstruction who took the operations from 11/1995 to ll/2007,Results In 112 cases, including 89 cases （79.5%） with chronic partial obstruction and 23 cases （20.5%） with acute complete obstruction. All the patients underwent operations researches, 98 cases performed onestage resection and anastomosis, 9 cases performed the hindgut resection and colostomy together with two-stage anastomosis, another 5 cases performed one-stage proximal colostomy and two-stage resection and anastomosis. The rate of one-stage colonic resection was 95.5%, 12 patients （ 10.7% ） with postoperative complications and 2 patients （ 1.8 % ） were dead. Conclusion colon cancer with intestinal obstruction aremostly chronic partial obstruction. Colon cancer is the major cause of acute complete obstruction. Early diagnosis and prompt operative treatment are crucial for the patient＇ s life. Colonic resection is the main operative way to release colon cancer with intestinal obstruction and the best operation way is the one - stage resection and anastomosis. Effective colonic lavement can increase the successful rate of this operation.