右半结肠与左半结肠肿瘤性肠梗阻一期切除吻合的比较

Comparison of one-stage resection and anastomosis of acute complete obstruction of right and left colonic carcinoma

目的:比较右半结肠与左半结肠癌肠梗阻一期切除吻合的近期结果。方法:回顾分析80例结肠癌肠梗阻行一期切除吻合患者的临床资料。结果:37例右半结肠癌及43例左半结肠癌肠梗阻患者行一期手术,2组患者平均住院时间为(31.6±12.8)dvs(29.6±14.8)d,P=0.518,平均住院费用为(52794.9±60804.3)元vs(50192.8±39727.4)元,P=0.817,并发症率分别为21.6%(8/37)vs25.6%(11/43),P=0.678,病死率为5.4%(2/37)vs2.3%(1/44),P=0.593,差异均无统计学意义。2组中各有1例发生吻合口瘘。结论:一期切除吻合对右半或左半结肠癌肠梗阻者同样安全。左半结肠吻合前,充分的结肠减压是必须的。

Objective： To compare the short-term result of one-stage resection and anastomosis for patients with acute complete obstruction of the right and left colonic carcinoma. Meth. mils： The clinical data of 80 patients undergoing emergency one-stage resection and anastomosis of acute complete obstruction for left and right colonic carcinoma were retrospectively analyzed. Results： Thirty-seven patients were operated on for obstructive Carcinoma of the right colon, the mortality was 5.4% （2/37）, the rate of complication was 21.6% （8/37）, the mean hospital stay and cost was （31.6 ± 12.8） d and （52794.9±60804.3） Yuan RMB, respectively. Forty-three patients were operated on for obstructive carcinoma of the left colon, the mortality was 2.3% （1/43）, the rate of complication was 25.6% （11/43）, the mean hospital stay and cost was （29.6 ±14.8） d and （50 192.8 ±39 727.4） Yuan RMB respectively. There was one case of anastomotic leakage in both groups. There were no significant differences of mortality and the rate of complication of the two groups. Conclusions： One-stage resection and anaStomosis of acute complete obstruction of left colonic carcinoma can be performed as safely as in those with acute obstruction of tight. Intraoperative decompression should be considered seriously in left colonic obstiuction prior to the anastomosis following colonic resection.