分析急诊Ⅰ期切除吻合术治疗梗阻性左半结肠癌的效果及预防再次手术的价值

The treatment effect of emergency stageⅠresection anastomosis for obstructive left colon cancer and the therapeutic value of preventing reoperation were analyzed

目的分析急诊Ⅰ期切除吻合术治疗梗阻性左半结肠癌的效果及预防再次手术的价值。方法选取本院2018年1月至2020年5月收治的梗阻性左半结肠癌患者60例作为研究对象,随机分为观察组和对照组,每组30例。对照组行分期结肠切除吻合术,观察组行Ⅰ期切除吻合术,比较两组淋巴结清扫情况、术后吻合口瘘发生率、临床疗效、再次手术率及围手术期指标。结果两组淋巴结清扫情况、术后吻合口瘘发生率、肠梗阻治疗有效率、再次手术率比较差异无统计学意义。观察组肛门排气时间、引流管拔除时间、自主下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论急诊Ⅰ期切除吻合术治疗梗阻性左半结肠癌疗效与分期手术相当,能有效清扫淋巴结,手术安全性较高,且不会增加再次手术的风险,能促进患者术后身体机能恢复,值得临床推广应用。

Objective To analyze the therapeutic effect of emergency stageⅠresection and anastomosis in the treatment of obstructive left colon cancer and the therapeutic value of preventing reoperation.Methods 60 patients with obstructive left colon cancer treated in our hospital from January 2018 to may 2020 were selected as study subjects and they were randomly divided into observation group and control group,with 30 cases in each group.The control group received staged colectomy and anastomosis,and the observation group received stageⅠresection and anastomosis.The lymph node dissection,the incidence of postoperative anastomotic leakage and clinical efficacy were compared between the two groups.Results There was no significant difference in lymph node dissection,incidence of postoperative anastomotic leakage,effective rate of intestinal obstruction treatment and reoperation rate between the two groups.The anal exhaust time,drainage tube extraction time,independent out of bed activity time and hospitalization time in the observation group were shorter than those in the control group,the difference was statistically significant(P<0.05).Conclusion The curative effect of emergency stage I resection and anastomosis in the treatment of obstructive left colon cancer is equivalent to that of staged surgery.It can effectively clean lymph nodes,has high surgical safety,does not increase the risk of reoperation,and can promote the recovery of patients’postoperative physical function,which is worthy of clinical application.