急性结肠癌性梗阻68例临床分析

Clinical analysis of 68 patients with acute colon obstruction caused by colon cancer

目的探讨急性结肠癌性梗阻病例的理想外科处理原则及方法。方法回顾性分析2000年1月至2011年12月间住院治疗的68例急性结肠癌性梗阻患者的临床资料,对其治疗效果进行总结分析。结果 68例中,一期切除吻合52例,其中右半结肠一期切除吻合28例,左半结肠一期切除吻合24例;行Hartmann一期肿物切除造口,二期闭瘘手术10例,肿瘤无法切除行单纯结肠造瘘和捷径手术6例。出现术后并发症10例,死亡1例,病死率1.5%。67例痊愈出院。结论正确的术中操作和围手术期处理前提下,一期切除吻合手术治疗结肠癌性梗阻是安全可行的。

Objective To study the principles and methods of surgical management for acute colon obstruction in patients with colon canc- er. Mothods Clinical data of 68 patients with acute colon obstruction caused by colon cancer treated in this hospital during January 2000 to De- cember 2011 were retrospectively analyzed. Results Among 68 patients with acute colon obstruction, primary resection and anastomosis was per- formed in 52 patients including 28 with right side lesions and 24 with left side lesions. Hartmann procedures was performed in 10 cases. For six pa- tients with unresectable lesions, colostomy or bypass operation was performed. Postoperative complications had been recorded in 10 patients. A- mong 68 patients, only one patient died after operation, and tile mortality rate was 1.5%. The remaining 67 cases were discharged from the hospi- tal. Conclusion A perfect procedure and perioperative management are crucial in improvement of curative effect. One stage tumor resection and anastomosis are safe and feasible procedures for treatment of acute colon obstruction caused by colon cancer.