Ⅰ期切除吻合治疗结肠癌并急性梗阻的围手术期处理

The perioperative management for one stage resection and anastomosis of colon carcinoma associated with acute obstruction

目的 总结I期切除吻合治疗结肠癌并急性梗阻的围手术期处理经验。方法 回顾1990年 1月至 1999年 12月经手术治疗的 78例结肠癌急性梗阻病例中 ,就其中行Ⅰ期切除吻合的4 9例 (左半结肠 33例、6 7.3% )临床资料进行总结分析。结果 经围手术期静脉使用有效的抗生素、加强术前准备、选择恰当病例及手术时机 ,术中彻底而无污染的肠减压及结肠灌洗 ,积极防治术后并发症 ,4 9例均治愈出院 ,术后并发吻合口瘘 1例、腹腔感染 3例。结论 选择合适病例、完善围手术期各项处理是Ⅰ期切除吻合的安全保证。

Objective To summarize the experience of perioperative management for one stage resection and anastomosis of colon carcinoma associated with acute obstruction.Methods Among 78 cases of carcinoma associated with acute obstruction between Jan. 1990 and Dec. 1999, 49 cases (left semicolon 33 cases, 67.3% ) underwent one stage resection and nastomosis, and related date were analyzed retrospectively.Results Through perioperatively intravenous injection of antibiotic, selection of cases and operative opportunity, on table colonic decompression and/or lavage without pollution and preventing postoperative complication, all 49 cases were cured and checked out. Postoperative anastomosis fistula occurred in one case and abdominal infection in 3 cases respectively. Conclusions It was necessary for one stage operative management to select proper cases and fulfill perioperative management.