经内镜肠梗阻导管治疗左半结直肠癌梗阻的临床应用

Application of transanal ileus tube in the treatment of left colorectal cancer with acute obstruction

目的:探讨电子结肠镜引导下肠梗阻导管减压术治疗急性左半结直肠梗阻的临床疗效。方法:收集2006-06-2010-08我院57例肠梗阻患者分为试验组(33例)和对照组(24例);对照组给予常规治疗,试验组在电子结肠镜引导下置入肠梗阻导管减压4～5d,再行手术治疗。比较分析两组手术方式及并发症的差异。结果:试验组2例置管失败,32例获得肿瘤切除,肠管Ⅰ期吻合,1例单纯结肠造瘘。对照组20例行肿瘤切除,术中结肠灌洗Ⅰ期吻合,术后刀口感染6例,感染发生率为25%(6/24);4例行肿瘤切除,近段结肠造瘘,3个月后行Ⅱ期吻合。结论:结肠镜引导下肠梗阻导管减压术治疗急性左半结直肠恶性梗阻安全且有效。

OBJECTIVE： To investigate the clinical effects of via colonscope ileus tube decompression in the treatment of acute left colorectal obstruction caused by colorectal carcinoma.METHODS： Fifty-seven cases of acute left hemicolon obstruction caused by colorectal carcinoma admitted to our hospital from June 2006 to August 2010 were divided into control group（n=24） and treatment group（n=33）.Patients in the control group were treated with routine medical therapy,and patients in the treatment group received via colonoscope ileus tube decompression for 4-5 days in addition to similar therapy in control group.The differenceson the operatire patterns and complications were statistically analyzed.RESULTS： Via colonscope ileus tube decompression was successfully carried out in 31 of 33 cases,primary and anastomosis was performed in 32 cases,colostomy was performed in only 1 case.Primary colectomy and anastomosis with intraoperative coloclyster was performed in 20 of 24 cases of control group,and 6 patients（25%） got incision infection.4 cases received tumor excision and proximal colostomy,delayed anastomosis was performed 3 month after operation.CONCLUSION： Via colonscope ileus tube decompression in acute left hemicolon obstruction caused by colon carcinoma is safe and effective.