左半结肠癌并梗阻Ⅰ期手术切除吻合的治疗体会

One-stage resection and primary anastomosis of the left colon cancer with acute obstruction

目的:探讨左半结肠癌并梗阻Ⅰ期手术切除吻合的治疗方法及围术期处理原则。方法:回顾性分析2005年5月～2010年5月Ⅰ期手术切除吻合左半结肠癌并梗阻患者20例的临床资料。结果:术后19例痊愈出院,无吻合口瘘,其中包括3例并发切口感染;1例放弃治疗,自动出院。结论:左半结肠癌并梗阻Ⅰ期手术切除吻合是比较安全可靠的治疗方法,但是也要严格掌握适应证,术中肠管闭式减压和结肠灌洗、围术期营养支持、高效广谱抗生素的应用、手术技术提高等是预防吻合口瘘的关键。

Objective： To evaluate the treatment and perioperative management of the left colon cancer with acute obstruction. Methods： Clinical data of 20 cases of the left colon cancer with acute obstruction operated upon one-stage resection and primary anastomosis from May 2005 to May 2010 were retrospectively reviewed. Results： All of the 19 cases were cured, there was no leaks. 3 cases occurred incision infection, 1 case gave up. Conclusion： One-stage resection and primary anastomosis of the left colon cancer with acute obstruction is safe, but the indication must be commanded strictly; bowel closed decompression and colonic lavage, perioperation nutritional support, using of efficient broad-spectrum antibiotic, the operation technology improvement are keys to prevent leaks.