结肠癌并急性肠梗阻手术治疗对策

Surgical countermeasure of acute intestinal obstruction caused by colon cancer

目的:探讨结肠癌并发急性肠梗阻行手术治疗策略。方法:回顾性分析94例结肠癌并发急性肠梗阻病例完整临床资料,比较不同部位病变下不同术式的选择情况及不同术式并发症的发生率。结果:左、右半结肠癌并发急性肠梗阻选择行Ⅰ期切除吻合术方式或分期手术方式选择比较差异无统计学意义(P>0.05),即不同部位结肠癌并发急性肠梗阻术式选择无明显区别。左、右半结肠癌并发急性肠梗阻行Ⅰ期切除吻合术,并发症发生率分别为14.3%、9.37%,不同部位结肠癌并发急性肠梗阻行Ⅰ期切除吻合术方式并发症发生率比较差异无统计学意义(F=0.349,P=0.69>0.05);左、右半结肠癌并发急性肠梗阻行分期手术,两组并发症率分别为46.7%、42.6%,两率比较差异无统计学意义(F=0.420,P=1.00>0.05),但左、右半结肠癌并发急性肠梗阻行Ⅰ期切除吻合术与行分期手术并发症的发生率比较差异有统计学意义(P<0.05)。行Ⅰ期手术并发症总发生率(11.7%)与行分期手术并发症总发生率(44.8%)比较差异有统计学意义(F=12.34,P=0.001<0.05)。即左、右结肠癌并发急性肠梗阻行Ⅰ期切除吻合术方式并发症发生率明显小于分期手术方式。结论:结肠癌并发急性肠梗阻的治疗对策是依据个体化情况,Ⅰ期切除吻合与分期手术结合,合理选择手术方式。

Objective To investigate the node operation treatment strategies for eolorectal carcinoma complicated with acute intestinal obstruction.Methods A retrospective analysis of the clinical data of 94 cases of colon cancer complicated with acute intestinal obstruction patients,the incidence of lesions under different choice of different surgical and surgical complications.Results The left,the right half colon carcinoma complicated with acute intestinal obstruction underwent one-stage resection or choice of staging operation mode selection had no significant difference（P 〉 0.05） anastomosis method,i.e, different parts of colon cancer complicated with acute intestinal obstruction operation type has no obvious difference.The left,the fight half colon carcinoma complicated with acute intestinal obstruction underwent one-stage resection and anastomosis,the complication rates were 14.3%,9.37%,different parts of colon cancer complicated with acute intestinal obstruction underwent one-stage resection and anastomosis way complication rate had no significant difference（F=0.349,P=0.69 〉 0.05）;the left,the fight half colon carcinoma complicated with acute intestinal obstruction staging operation,two complications rates were 46.7%,42.6%,no significant difference in prevalence of two（F=0.420,P=1.00 〉 0.05）,but the left,the right half colon carcinoma complicated with acute intestinal obstruction underwent one-stage resection and anastomosis with staging operation complication rate difference was statistically significant（P 〈 0.05）.The total incidence rate for one-stage operation complications（11.7%） the total incidence and staging operation complications（44.8%） had significant difference （F=I 2.34p=0.001 〈 0.05）.Left,right colon cancer complicated with acute intestinal obstruction underwent one-stage resection and anastomosis complication rate was smaller than the way staging operation mode.Conclusion The treatment of colon cancer complicated with acute intestinal obstruction is based on individual circumstances,one-stage resection and anastomosis with staging operation combined with,reasonable selection of operation mode.