左半结肠癌并发急性肠梗阻的手术疗效分析

Surgical curative effect analysis of left colon cancer complicated with acute intestinal obstruction

目的回顾性分析左半结肠癌并发急性梗阻的外科诊治效果。方法总结65例左半结肠癌引起急性梗阻的病例资料,手术前均行CT检查。按手术方式分组:观察组:I期左半结肠切除术35例,对照组:分期手术30例,比较两组的治疗效果和预后。结果 CT检查对结肠癌致肠梗阻的检出率较高,诊断符合率(93.84%,61/65),能够提供良好的诊断依据。A组的并发症发生率为20.00%,明显高于B组的9.14%(P<0.05);A组的手术后1年生存率分别为100.00%,B组为97.00%,组间比较无统计学差异(P>0.05)。结论 I期左半结肠切除术治疗结肠癌并发梗阻应当根据病情慎重选择。从并发症发生率和临床预后来看,I期左半结肠切除术较高,但是两组1年生存率无统计学差异。值得注意的是年龄大、病情严重、病史较长者仍以分期手术为首选。

Objective： To retrospectively analyzed the surgical treatment of left colon cancer complicated with acute obstruction. Methods： Summarize cases data of 65 cases with acute obstruction caused by left colon cancer,Before the operation were performed CT examination. according to the operation group： Observation group： phase I left half colon resection35 cases,control group： 30 cases of staging surgery,compare the treatment effect and prognosis of two groups. Results：The CT examination for colon cancer to intestinal obstruction detection rate is higher, Diagnostic coincidence rate（ 93. 84%,61/65）,can provide a good diagnostic basis. The complication rate of group A was 20. 00%,significantly higher than the 9. 14% of the group B（ P〈0. 05）; Group A after surgery,1 year survival rates were 100. 00%,B group was 97. 00%,the comparison between groups have no statistical difference（ P 005）. Conclusion： The stage I left half colon resection for colon cancer complicated by obstruction is a safe and feasible,and from the point of incidence of complications and clinical prognosis,stage I left half colon resection is higher,but the two groups of 1 year survival rate was no statistical difference,it is worth noting that the history of the disease is severe,the elderly are still on easy operation is first selection.