68例大肠癌并发肠梗阻的外科治疗

Surgical Treatment of Large Bowel Obstruction Caused by Colorectal Carcinoma

目的 :探讨大肠癌并发肠梗阻的外科治疗方法 .方法 :回顾性分析 1990至 2 0 0 1年收治手术的 6 8例大肠癌致肠梗阻病例资料 .结果 :6 8例患者中一期行右半结肠切除 14例 ;一期行左半结肠切除 30例 ;一期行左半结肠或直肠上段癌切除 ,近端结肠造瘘 ,封闭远端结肠或直肠二期吻合 17例 ;直肠癌晚期无法切除根治行乙状结肠造瘘 7例 .术后并发症发生 13 2 3% (9/6 8) ,围手术期死亡 4 4 1% (3/6 8) .结论 :提高对本病的认识 ,根据病情合理选择外科治疗方法 。

Objective: To study the surgical treatment of large bowel obstruction caused by colorectal carcinoma. Methods: Retrospective analysis of the experience of surgical treatment for the large bowel obstruction caused by colorectal carcinoma in 68 patients from 1990 to 2001 was performed. Results: In the 68 patients, the right hemicolectomy was performed in 14 patients; left hemicolectomy was performed in 30 patients; left hemicolectomy with proximal colon fistulization was performed in 17 patients; sigmoid fistulization was performed in 7 patients because their rectum carcinomas couldt be resected. The postoperative complication rate was 13 23% (9/68), and perioperative mortality rate was 4 41% (3/68). Conclusion: 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.