外科手术治疗结肠癌继发肠梗阻的临床疗效调查与分析

Clinical Investigation and Analysis of Surgical Treatment of Secondary Intestinal Obstruction Caused by Colon Cancer

目的对结肠癌继发肠梗阻的外科手术疗效进行调查与分析,以寻求最佳手术方案。方法选取2013年5月—2014年5月来我院进行治疗的64例结肠癌继发肠梗阻患者的临床资料,对其进行汇总与分析。其中,28例患者为右半结肠癌继发肠梗阻,采取右半结肠I期切除和回肠横结肠吻合术;26例左半结肠癌继发梗阻患者,采取左半结肠I期切除和吻合术,7例左半结肠癌继发梗阻患者采取左半结肠I期切除和近端造瘘远端关闭术,3例患者采取横结肠I期切除和吻合术。结果患者在术后3~6天出现排气、排便,平均时间为(3.94±0.59)d;共有7例患者在术后出现并发症,均为感染。其中,5例患者发生切口感染、2例患者发生腹腔感染,但在给予相应的抗生素治疗后均被治愈。出院后进行随访,3年内(0.5、1、2、3年)的生存率分别为:81.25%、68.75%、56.25%、50.00%。结论对于结肠癌继发肠梗阻的患者,在进行手术治疗时要充分考虑个体病情差异,根据具体病情制定个性化手术方案并进行相应的手术治疗后,可使患者的肠梗阻情况好转至痊愈。

Objective To investigate and analyze the effect of surgical treatment of secondary intestinal obstruction caused by colon cancer, so as to seek the best operation plan. Methods The clinical data of 64 cases of secondary intestinal obstruction caused by colon cancer treated in our hospital from May 2013 to May 2014 were collected and analyzed. Among them, 28 patients with right colon cancer with intestinal obstruction, take the right colon resection and ileotransversostomy I, 26 patients with left colon cancer secondary obstruction were treated with 1 resection and anastomosis of left colon, 7 cases of left colon cancer secondary obstruction were treated with left colon resection at I stage and distal closure of proximal colostomy, 3 patients take I stage resection and anastomosis of colon. Results The patient had air and bowel movements 3-6 days after surgery, an average time of （3.94 ~ 0.59） d. A total of 7 patients had postoperative complications, all of which were infections. Among them, 5 cases had incision infection, 2 cases had abdominal infection, but they were cured after given corresponding antibiotic treatment. All the patients were followed up for 3 years （0.5, 1, 2, 3 years）. The survival rates were 81.25%, 68.75%, 56.25%, 50.00% respectively. Conclusion For colon cancer secondary to intestinal obstruction in patients, surgical＇treatment should be considered when the condition of individual differences, according to the specific conditions of personalized surgical procedures and appropriate surgical treatment, the intestinal obstruction patients improved to heal.