左半结肠癌性肠梗阻的治疗进展

Progress in the management of obstructing cancer of the left colon

结直肠癌性肠梗阻是常见的外科急腹症之一,8.0％～33.9％的结直肠癌患者首发症状表现为急性完全或不全机械性肠梗阻.约70％结直肠癌性肠梗阻位于左半结肠.对于左半结肠癌性肠梗阻的治疗,目前尚无统一标准.传统的治疗方法是分期手术,随着肠道疾病治疗方法的改进,目前多数学者倾向一期手术,一期切除吻合方法目前主要有：术中结肠灌洗、结肠次全切除术、金属支架置入、经肛肠梗阻导管置入.且术前金属支架置入和经肛肠梗阻导管置入减压的应用,使腹腔镜技术得以应用于恶性结直肠梗阻患者的治疗.

Obstructing colorectal cancer is one of the acute abdominal diseases which are common in clinical practice.The initial symptoms of 8.0%-33.9% patients with obstructing colorectal cancer are complete or incomplete acute colonic obstruction.Seventy percent of obstructing colorectal cancer located at the left colon.There are no standard treatment methods for obstructed left colonic carcinoma （OLCC）.Previously,a staged procedure was recommended.With the improvement of the intestinal surgical techniques,one-stage resection and anastomosis including intraoperative colonic irrigation,subtotal colectomy,metal stents placement and transanal drainage tube placement were preferred by most of the surgeons.In addition,metal stents placement and transanal drainage tube placement can reduce bowel pressure,which creates the possibility for the treatment of malignant colorectal obstruction by laparoscopes.