结直肠癌并急性肠梗阻68例临床分析

Evaluation of surgical management of colorectal carcinoma with acute intestinal obstruction

目的:探讨结直肠癌并急性肠梗阻患者的外科处理方法,观察其手术效果。方法:回顾性分析我院2002～2008年收治的结直肠癌并急性梗阻68例患者临床资料,61例行一期切除吻合,肿瘤广泛转移、行肠捷径手术2例,造瘘5例患者行二期肠吻合。结果:术后出现并发症16例,吻合口漏2例(2.94%),切口感染6例(8.82%),肺部感染6例(8.82%),心肺功能不全1例(1.47%),急性肾功能不全1例(1.47%)。住院10～50d(包括术后化疗),近期治愈100%。随访3年者57例,45例(79.00%)生存;随访5年者39例,17例(43.59%)生存。结论:综合分析结直肠癌并急性肠梗阻患者的病情,合理选择术式,加强围手术期管理对减少并发症、提高疗效起重要作用。

Objective： To assess the surgical management of colorectal carcinoma with acute intestinal obstruction. Methods： Clinical data of 68 patients with colorectal carcinoma complicating acute intestinal obstruction treated by surgical procedures in our hospital from 2002 to 2008 were studied retrospectively. 61 patients underwent resection of tumor and anastomosis, two patients with extensive metastases underwent short-cut operation of intestine, five patients underwent fistula and Phase II anastomosis. Results： There were 16 cases with postoperative complications, including two cases of anastomotic leakage （2.94%）, six cases of wound infection （8.82%）, six cases of lung infection （8.82%） , one case of cardio-pulmonary insufficiency （ 1.47% ） , one case of acute renal insufficiency （1.47%）. The time of hospitalization was 10- 50 d （including postoperative chemotherapy）. The recent curative rate was 100%. Of 57 cases follow-up of 3 years, 45 cases （79.00%） were in survival. Of 39 cases follow-up of 5 years, 17 cases （43.59%） were in survival. Conclusion： Comprehensive evaluation of conditions of patients, reasonable choice of surgical procedures and intensive perioperative management were keys to reduce complications and improve effects for patients with colorectal carcinoma complicating acute intestinal obstruction.