左半结肠癌合并肠梗阻一期切除吻合可行性研究

Feasibility of one-stage resection and anastomosis in the treatment of left colon cancer with obstruction

目的:探讨左半结肠癌合并肠梗阻一期切除吻合的可行性。方法:回顾性分析331例左半结肠癌患者临床资料,其中95例合并肠梗阻,27例行一期切除吻合,68例行Hartmann手术。比较一期切除吻合组与Hartmann手术组临床疗效。结果:一期切除吻合组与Hartmann手术组相比,术后肺部感染、切口感染及尿路感染的发生率、围手术期死亡率、手术时间无显著性差异(P>0.05);总住院时间及总住院费用明显低于后者(P<0.05)。结论:左半结肠癌合并肠梗阻,在选取合适病例的基础上,经积极适当术前准备改善肠梗阻状态,术中合理有效的肠道减压及局部肠腔灌洗,行一期切除吻合是可行的。

O bjective： To investigate the feasibility of one-stage resection and anastomosis in the treatment of left colon cancer with obstruction. Methods：The clinical data of 331 patients with left colon cancer were analyzed retrospectively. Ninety five cases were with obstruction, among which 27 cases underwent one stage-resection and anastomosis and 68 cases underwent Hartmann routine surgery. The clinical effects were compared between one-stage resection and anastomosis group and Hartmann surgery group. Results：One-stage resection and anastomosis group was compared with the Hartmann surgery group, with no significant difference in postoperative pulmonary infection, wound infection and urinary tract infections, perioperative mortality and operative time（P〉0.05）. The length of hospitalization and total costs were significantly lower than the latter（P〈0.05）. Conclusion：With positive preoperative preparation, selection of the appropriate patients, reasonable and effective intestinal decompression, local lavement of the proximal and distal segment of colon, one-stage resection and anastomosis of left colon cancer with obstruction is feasible.