左半结肠癌致肠梗阻一期切除52例临床分析

The clinical analysis of one-stage resection of left colon cancer with obstruction in 52 patients

目的 探讨左半结肠癌致肠梗阻一期切除的围手术期处理及手术方式的选择。方法 对 5 2例左半结肠癌致肠梗阻行一期切除资料进行回顾性分析。结果 行Hartmann术 3例 ,一期切除吻合 49例 ,其中 8例行结肠近端造口 ,4例吻合口外置。死亡 2例 ,发生吻合口漏 4例。结论 左半结肠癌致肠梗阻行一期切除时应根据病人的具体情况采用相应的手术方式 ,一期切除吻合具有一定风险性 。

Objective To study the perioperative management and operative procedures in patients with one-stage resection of obstructive carcinoma of left colon.Method 52 patients with one-stage resection of obstructive carcinoma of left colon were analyzed restropectively.Results Hartmann's procedure was performed on 3 cases,49 cases underwent one-stage resection and anastomosis,of that 8 were operated with proximal colonic stoma,4 with anastomotic exteriorization,2 patients were dead and 4 cases were complicated with anastomotic leakage.Conclusions Operation in patients with one-stage resection of obstructive carcinoma of left colon should be based on local circumstance.Some risks exsit in one-stage resection and anastomosis.At the same time,the pefect perioperative managment and operative effective colonic lavage were contributive to decreasing postoperative complications and mortality.