结直肠癌合并非绞窄性肠梗阻的手术治疗分析

Surgical Treatment of Colorectal Cancer Patients with Non-strangulated Intestinal Obstruction

目的探讨结直肠癌合并肠梗阻的最佳手术治疗方案。方法回顾性分析我院自2006年7月～2008年12月结直肠癌合并肠梗阻手术治疗的27例患者临床资料,总结治疗效果和最佳的治疗策略。结果27例患者均行手术治疗,11例行Ⅰ期吻合术,吻合口瘘发生率为18.5%(5/27),均为左半结肠吻合术后患者,占左半结肠Ⅰ期吻合的38.5%(5/13),Ⅰ期造瘘待Ⅱ期吻合5例,分别于6周至～3个月后成功进行Ⅱ期手术;全组Ⅰ期手术切口感染率14.8%(4/27),腹腔感染7.4%(2/27),无死亡病例,住院时间(21.5±18.2)d,住院费用(6877.2±5355.5)元。结论在治疗结直肠癌合并肠梗阻的病例时,要根据患者全身情况及肠管、肿瘤的局部情况确定合理术式。

Objective To analyze the surgical treatment of colorectal cancer patients with non-strangulated intestinal obstruction in order to find out the best treatment for this kind of patients. Methods Retrospective analysis of clinical documents of 27 patients with colorectal cancer complicating intestinal obstruction,who were treated in our hospital from Jul.2006 to Dec.2008. Results Twenty-seven patients were treated by surgery ,and 11 patients underwent anastomosis in the first stage,the incidence of anastomotic stoma leakage being 18.5%（5/27）. All the 5 leakage cases occurred in the left hemicolon,the incidence of leakage accounting for 38.5%（5/13）in the left hemicolon operation patients. The incidence of postoperative infection and peritoneal cavity infection were 14.8% （4/27）and 7.4% （2/27）, respectively.Length of stay and cost in hospital were （ 21.5 ± 18.2 ）days and （6877.2± 5355.5 ）RMB, respectively. Conclusion The colorectal cancer patients with non-strangulated intestinal obstruction should be treated by surgery according to the whole condition of patients and the local condition of intestine or coloreetal tumor.