结直肠癌急性肠梗阻一期切除吻合的共识与争议

Consensuses and controversies on one-stage resection and anastomosis surgery in patients with acute obstructive colorectal cancer

急性肠梗阻是结直肠癌病人行急诊手术常见的原因之一,预后通常较差。手术是解除梗阻、挽救病人生命最重要的方法。一期切除吻合术可通过一次手术完整切除肿瘤、恢复肠道的连续性、避免分期手术并发症并减少疾病负担,理应为最理想的手术方式。但由于尚存在一定的手术技术难点、吻合口漏发生的风险等原因,目前在手术探查时能否首选行一期切除吻合尚存争议。

Acute intestinal obstruction is one of the common causes of emergency surgery in patients with colorectal cancer,which is usually with poor prognosis. Surgery is the most important way to relieve obstruction and save the lives. One-stage resection and anastomosis can completely remove the tumor, restore the continuity of the intestine, avoid complications of staged surgery and reduce disease burden,and is supposed to be the most ideal surgery. However,due to certain intraoperative technical difficulties and the risk of anastomotic leakage,it is still controversial whether the one-stage resection and anastomosis surgery can be preferred during emergency exploration.