金属支架植人一期切除吻合术治疗不完全梗阻性左半结肠癌33例疗效分析

Primary Resection and Anastomosis Following Metallic Stent Implantation in the Treatment of Uncomplete Obstructional Left Colonic Carcinoma of 33 Cases

为探讨金属支架植入一期切除吻合术治疗不完全梗阻性左半结肠癌的疗效，对2010年1月至2011年12月我院收治的33例不完全梗阻性左半结肠癌患者应用该法治疗，具体方法：先通过腹部CT及x线片检查等评估肠梗阻严重程度，然后于内镜下行肿瘤占位肠管处金属支架植入术，1周后行开腹左半结肠癌一期切除吻合术。结果显示，33例患者金属支架植入均成功。其中2例患者支架植入后3h左右出现腹膜炎体征，考虑肠穿孔，2例患者支架植入后第5天再次出现肠梗阻，急诊行肿块切除近端结肠造LI远端肠管封闭术；余29例患者均成功完成左半结肠癌一期切除吻合术，术后未发生严重并发症。结果表明，金属支架植入一期切除吻合术治疗不完全梗阻性左半结肠癌安全有效，是一种可避免二次于术的理想术式。

In order to explore the curative effect of primary resection and anastomosis following metallic stent implantation for treating uncomplete obstructional left colon carcinoma,the 33 patients with this dis- ease enrolled in this study who were admitted in author＇s hospital（Jan. 2010--Dec. 2011yr. ） were subjected to above therapy,i, e firstly,by using abdominal CT and X-ray to evaluate the severity of intestinal obstruc- tion,then under endoscope to perform metallic sten implantation at intestinal canal occupied by neoplasms, later one week to perform open primary resection ~ anastomosis. As results, in all the patients metallic stent was successfully implanted,in 29 cases of them resection and anastomosis were performed successful- ly,and there were no postoperative severe complication; the outcomes of rest 4 cases were as follow： after implantation of metallic stent later 3 hrs 2 cases suffered from peritonitis symptoms and signs suspected as intestinal per{oration,2 cases on the 5th day after implantation again had intestinal obstruction and were e- mergently subjected to following procedure：resection of mass,colostomy at near end and closure of distant intestinal canal. Results show that primary resection and anastomosis following metallic stent implantation for treating uncomplete obstructional left colonic carcinoma is safe and effective, and is an ideal procedure which can protect from secondary surgery.