31例大肠癌致肠梗阻的外科治疗分析

Analysis of surgical treatment of 31 cases with large bowel caused by colorectal

目的:探讨大肠癌致肠梗阻的外科手术治疗方法。方法:回顾分析本院1999年1月～2001年12月期间31例大肠癌致肠梗阻病人的外科手术治疗资料。结果:31例大肠癌致肠梗阻病人,手术行Miles4例,Dixon2例,右半结肠Ⅰ期切除吻合7例,左半结肠Ⅰ期切除吻合9例,左半结肠Ⅰ期行肿瘤切除、Hartmann肠造口术4例,剖腹探查活检加结肠造口术3例,仅剖腹探查活检2例。术后产生并发症12例(占38.7%),死亡2例(占6.45%)。结论:重视对大肠癌致肠梗阻的认识,选择合理术式,加强围手术期处理,是保证手术的安全性,减少并发症的发生,提高疗效的重要措施。

Objective To study the surgical treatment of large bowel obstruction caused by colorectal carcinoma. Methods All 31 cases with large bowel caused bycolorectal from January 1999 to December 2001 in Huangshan hospital were analyzed retrospectively. Results In 31 cases, Miles was performed in 4 cases; Dixon was performed in 2 cases; the right hemicolectomy and anastomosis were performed in 7 cases; the left hemicolectomy and anastomosis were performed in 9 cases; the left hemicolectomy and Hartmann fistulization were performed in 4 cases; exploratory laparotomy and biopsy and colon fistulization were performed in 3 cases; just exploratory laparotomy and biopsy were performed in 2 cases.The postoperative complications occurred in 12 cases(the complication rate was 38.7%),2 cases died(the mortality rate was 6.45%). Conclusions More attention should be paid to large bowel obstruction caused by colorectal carcinoma.Selecting rational colectomy and appropriate perioperative management is important for reducing both complication and mortality rate.