左半结肠癌并梗阻行术中灌洗加一期吻合安全性研究

Safety study of one-stage resection and anastomosis with intraoperative irrigation in treating left semicolon carcinoma associated with obstruction

目的探讨术中灌洗加一期吻合治疗左半结肠癌患者发生急性肠梗阻的安全性。方法 2010年7月至2013年7月我院行术中灌洗加一期吻合治疗的50例左半结肠癌急性肠梗阻患者为观察组,同期行分期手术治疗的40例左半结肠癌急性肠梗阻患者为对照组,比较两组患者的围手术期情况和术后并发症发生情况。结果观察组患者的手术时间长于对照组,而住院时间短于对照组,差异有统计学意义(P<0.05),在术中出血量、肛门排气时间、进食流质时间等方面,两组患者无明显差异(P>0.05);观察组中,有1例出现下肢静脉血栓、1例发生急性心肌梗死、1例患者发生切口感染、1例患者发生肺感染、1例患者发生吻合口漏,并发症发生率为10%;对照组中,有1例患者出现下肢静脉血栓、1例患者发生切口感染、1例患者发生肺感染,并发症发生率为7.5%,差异不具有统计学意义(P>0.05)。结论行术中灌洗加一期吻合治疗左半结肠癌并发急性肠梗阻,效果确切,安全可靠,能使患者免受多次手术之苦,降低住院时间,减少住院费用。

Objective To investigate the security of one-stage resection and anastomosis with intraoperative irrigation in treating left semicolon carcinoma associated with obstruction.Methods A retrospective analysis of clinical data from July 2010 to July 2013 was conducted.Fifty cases of left colon cancer with acute intestinal obstruction patients were treating with one-stage resection and anastomosis intraoperative irrigation were selected as observation group.Forty stage operation patients with left colon cancer with acute intestinal obstructionas were selected as control group.The perioperative and postoperative complications of two groups compared were compared.Results The operative time of observation group was longer than control group,and the hospital stay was shorter than control group,which was statistically significant（P〈0.05）.In the amount of bleeding,flatus,time of starting liquid food,there was no significant difference between the two groups（P 〉0.05）.patient in observation group received intraoperative lavage plus an anastomosis During the treatment period,there was 1patient developed deep vein thrombosis and acute myocardial infarction,one patient had wound infection,one patient had pulmonary infection,and 1patient had anastomotic fistula,with complication rate was 10%.In the stage surgical treatment of patients in the control group,one patient developed deep vein thrombosis,one patient had wound infection and one patient had lung infection,with complication rate was 7.5%.The difference was not statistically significant（P〉0.05）.Conclusion One-stage resection and anastomosis with intraoperative irrigation in treating left semicolon carcinoma associated with obstruction has exact effect.It is safe and reliable,enabling patients avoid the pain of multiple surgeries,reducing hospital stays and hospital costs.