经阑尾腔插管灌洗一期切除吻合术治疗急性梗阻性左半结肠癌

Epityphlon Cavity Intubation Perfusion Stage-Ⅰ Resection-stomy Treat Acute Intestinal Obstruction Left Colon Cancer

[目的]探讨急性肠梗阻(Intestinal obstruction,IO)左半结肠癌(colon cancer,CC)术中行经阑尾腔(appendix cavity,AC)插管灌洗Ⅰ期肠切除吻合术(Intestinal resection and anastomosis,IRAA)的治疗方法和可行性。[方法]对比分析采用术中经AC插管灌洗Ⅰ期肠切除吻合术(A组,37例)和Ⅰ期肿瘤切除,近端结肠造口,Ⅱ期吻合(B组,35例)治疗急性梗阻性左半CC患者的疗效。[结果]手术时间A组长于B组(Ⅰ期手术时间)。A组共发生术后并发症9例,其中吻合口漏1例,切口感染5例,肺部感染3例;B组术后并发症8例,其中吻合口漏1例,切口感染4例,肺部感染3例,术后两组并发症发生率比较无显著性差异(P>0.05)。[结论]经AC插管灌洗Ⅰ期肠切除吻合术和Ⅰ期切除、Ⅱ期吻合术均为治疗急性IO左半CC的有效处理方法,在严格掌握适应症的前提下,经AC插管灌洗Ⅰ期肠切除吻合术,不仅具有操作简单、肠道准备彻底、无瘤的优点,而且安全可行。

[Objective]To explore the therapy and availability of IO left CC with AC treated with IRAA. [Method] The comparative analysis takes operational AC intubation perfusion for stage-1 IKAA（group A, n=37） and tumor resection, with colon stoma at near-end; stage-2 anastomosis（group A, n= 35） treats acute IO left CC. [g.esult]On operation time, group A was longer than B. 9 cases had post-operation complication in group A, among which, one had stomal leak, 5 of incisional wound infection, and 3 of lung function; in group B, there＇re 8 having complication, among which, 1 of stomal leak, 4 of incisional wound infection and 3 of lung infection. There＇s no marked difference on complication occurrence rate between them. [Conclusion] The effective method of AC intubation perfusion stage-1 IO and stage-1 and stage-2 anastomosis for acute IO left CC is not only simple in operaiton, with thorough intestinal preparation, without tumor, but safe and available under strict indications.