两种方法治疗左半结肠癌并发肠梗阻的疗效比较

The clinical analysis of operation after colon bracket insertion in cancerous obstruction in left hemicolon

目的比较结肠内支架解除梗阻后Ⅱ期结肠癌根治术与术中大肠灌洗I期切除吻合术的临床效果。方法选择32例左半结肠癌并发肠梗阻患者，遵照患者意愿行结肠内支架解除肠梗阻后Ⅱ期结肠癌根治手术（支架组）14例和术中大肠灌洗I期切除吻合术（I期吻合组）18例，观察比较两组手术时间、术后并发症发生率、术后引流量、住院时间等。结果支架组均一次性成功放置结肠内支架，Ⅱ期结肠癌根治吻合术顺利，未发生吻合口漏和腹腔感染等，并发切I：3感染1例；手术时间（115±26）rain，术后3d内引流量（127±66）ml，住院时间（12．5±3．2）d。I期吻合组手术时间（210±39）min，术后引流量（175±57）ml，住院时间（14．8±2．6）d，并发吻合口漏2例、切口感染12例，死亡7例。两组手术时间、术后引流量、住院时间、吻合口漏及切口感染发生率等差异均有统计学意义（均P〈0．05）。结论结肠内支架解除梗阻后Ⅱ期结肠癌根治手术与术中灌洗I期切除吻合术相比较，术后恢愎快，并发症少。

Objective To explore the effect of the treating left colon cancer,Compare left colon irrigation at one-stage radical colon resections were performed with the way which is given colon bracket insertion operation then two-stage radical colon resections were performed. Methods 32 cases sigmoid and rectum cancer patients with obstruction were received. And 14 cases were treated by colon irrigation at one-stage radical colon resections; 18 cases were treated by colon bracket insertion operation then two-stage radical colon resections were performed. To analyze the complications of after-operation,the average time in hospital. Results No oecurence of anastomotie leakage was found in the two-stage radical colon resections. There was only one case was infected;the operation time （ 115 ± 26） min. The drainage in 3 days after the operation（ 127 ± 66 ）ml,length time （12.5 ± 3.2 ）d. The group of one-stage radical eolon resections：the operation time（210 ± 39）min. The drainage in 3 days after the operation, length time（ 14.8 ± 2.6） d,There was two cases of anastomotic leakage and 12 cases were infected and two dead were found in this group. Conclusion The way which was given colon bracket insertion operation then two-stage radical colon resections were performed, was better than colon irrigation at one-stage radical colon resections were performed, and with the first way patients life quality enhanced.