Ⅰ期切除吻合术治疗左半结肠癌并急性肠梗阻的可行性分析

Feasibility analysis of phase Ⅰ resection and anastomosis in treatment of left colonic carcinoma combined with acute intestinal obstruction

目的探讨Ⅰ期切除吻合术治疗左半结肠癌并急性肠梗阻的可行性分析。方法回顾性分析96例左半结肠癌并急性梗阻患者的临床资料,其中行Ⅰ期切除吻合术的50例患者为观察组,行左半结肠癌根治术的46例患者为对照组,比较两组患者术后淋巴结的清除数量、术后进食时间、并发症发生率、住院时间、复发和转移率。结果观察组术后淋巴结清除数量为(13.3±1.8)枚、术后进食时间为(3.6±0.9)d、并发症的总发生率为8.00%、住院时间为(12.4±0.9)d、复发和转移率为4.00%;对照组术后淋巴结清除数量为(12.8±1.5)枚、术后进食时间为(3.2±0.8)d、并发症的总发生率为8.70%、住院时间为(11.7±1.5)d、复发和转移率为4.35%;两组间比较差异无统计学意义(P>0.05)。结论对左半结肠癌并发急性肠梗阻患者,应严格掌握手术适应证,有效的术中结肠灌洗和术前、术后的正确处理,左半结肠癌并急性肠梗阻行Ⅰ期切除吻合术是安全可行的,术后并发症无明显增加,可避免二次手术的痛苦,住院时间短,费用低,值得进一步探讨、改进和推广。

Objective To investigate the feasibility of phaseⅠresection and anastomosis in the treatment of left colonic carcinoma combined with acute intestinal obstruction.Methods Clinical information of 96 patients with left colonic carcinoma combined with acute intestinal obstruction was retrospectively analyzed,in which 50 patients who received phaseⅠresection and anastomosis were assigned to the observation group and 46 patients who received left colon radical operation were assigned to the control group.The removal number of lymph nodes,postoperative feeding time,the incidence of complications,hospital stay,recurrence and metastasis of the two groups were compared.Results The observation group had a removal number of lymph nodes of（13.3±1.8）,postoperative feeding time of（3.6±0.9） days,a total incidence of complications of 8.00%,hospital stay of（12.4 ±0.9） days and a recurrence and metastasis rate of 4.00%;The control group had a removal number of lymph nodes of（12.8±1.5）,postoperative feeding time of（3.2±0.8） days,a total incidence of complications of 8.70%,hospital stay of（11.7±1.5） days and a recurrence and metastasis rate of 4.35%;The two groups had no significant difference（P＆gt;0.05）.Conclusion For patients with left colon carcinoma combined with acute obstruction,the surgical indications should be mastered strictly and the effective intraoperative coloclysis and preoperative and postoperative treatment should be implemented.In the treatment of left colonic carcinoma combined with acute intestinal obstruction,phase Ⅰ resection and anastomosis is safe and feasible,can avoid the pain of secondary surgery,shows short hospital stay and causes low cost,thereby worthy of further exploration,improvement and promotion.