结直肠癌合并急性结肠梗阻36例的外科治疗体会

Study on surgical management of acute colon obstruction caused by colorectal cancer in 36 cases

目的探讨结直肠癌并急性结肠梗阻病例的外科处理原则和方法。方法回顾性分析自2005年至2010年收治的36例结直肠癌并急性结肠梗阻病例的外科治疗情况。结果 36例患者均经手术治疗,痊愈33例,死亡3例,病死率为7.7%,30例属中晚期,占83.3%;术前有并存病31例,占86.1%;一期切除肿瘤31例,切除率为86.1%;术后并发症16例,占44.4%。结论结直肠癌并急性结肠梗阻的治疗要根据病人的全身情况和肿瘤的局部情况来进行综合判定。适应证掌握恰当,一期肿瘤切除和吻合术是安全的。

Objective To explore the principles in surgical treatment of acute intestinal obstruction in patients with colorectal cancer. Methods The clinical data of surgical treatment in 36 patients with acute intestinal obstruction caused by coloreetal cancer during 2005 to 2010 were retrospectively analyzed. Results All these 36 patients were operated, 33 of them cured, 3 died, and the mortality rate was 7.7%. Thirty of them were in middle - late stage （ 83.3% ） , 31 patients had coexisting diseases （ 86.1% ） and 31 patients had undergone with single - stage tumor resection, the resection rate was 86.1%. Sixteen patients had postoperative complications （44.4%）. Conclusion More attention should be paid to perioperative management. Effective colectomy should be selected according to the general condition of patients and local condition of cancer. It is important to appropriately master the indication, then single - stage resection and anastomosis may be safe and suitable for surgical treatment of patients with colorectal cancer.