摘要
目的:探讨手术治疗结肠癌并发急性肠梗阻的临床经验,进一步提高临床疗效。方法:2012年1月-2014年1月收治结肠癌并发急性肠梗阻患者80例,采用肿瘤切除+乙状结肠吻合+吻合口近端结肠造瘘13例(16.25%);单纯结肠造瘘8例(10.0%);单纯结肠造瘘,Ⅱ期肿瘤切除术11例(13.75%);术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术28例(35.0%);肿瘤切除+近端结肠造瘘,Ⅱ期消化道重建术20例(20.0%)。结果:所有患者均痊愈出院,其中2例发生吻合口瘘,均是术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术式,肿瘤切除+近端结肠造瘘、Ⅱ期消化道重建术式中1例患者出现切口感染。术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术式和肿瘤切除术+乙状结肠吻合+吻合口近端结肠造瘘术式、肿瘤切除+近端结肠造瘘术式,单纯结肠造瘘及Ⅱ期肿瘤切除术式、Ⅱ期消化道重建术式症状缓解时间、肛门排气时间、住院时间明显高于单纯结肠造瘘术式。结论:手术治疗结肠癌并发急性肠梗阻是首选的治疗方法,应该根据患者的自身情况选择具体术式。
Objective:To explore the clinical experience of operation treatment of colon cancer combined with acute intestinal obstruction,to further enhance the clinical curative effect.Methods:80 patients with colon cancer combined with acute intestinal obstruction were selected from January 2012 to January 2014.13 cases(16.25%) were given tumor resection,sigmoid colon anastomosis joint proximal colon anastomotic fistula.8 cases(10.0%) were given simple colon fistula.11 cases(13.75%) were given pure colostomy and Ⅱ the colon tumor resection.28 cases(35.0%) were given intraoperative colonic lavage + radical tumor resection and sigmoid colon/rectum end anastomosis.20 cases(20.0%) were given tumor resection and proximal colostomy,the colon Ⅱ of digestive revascularization.Results:All patients were cured and discharged,including 2 cases of anastomotic fistula were intraoperative colonic lavage+radical tumor resection and sigmoid colon/rectum end anastomosis.1 patient of tumor resection and proximal colostomy,the colon Ⅱ of digestive revascularization had incision infection.In the intraoperative colonic lavage+radical tumor resection and sigmoid colon/rectum end anastomosis,tumor resection,sigmoid colon anastomosis joint proximal colon anastomotic fistula,tumor resection and proximal colostomy,pure colostomy and Ⅱ the colon tumor resection,the colon Ⅱ of digestive revascularization,the symptom remission times,anal exhaust times, hospitalization times were significantly higher than that of simple colon fistula.Conclusion:The operation treatment of colon cancer combined with acute intestinal obstruction is the preferred treatment method.It should be based on the patient's own situation to select the specific operation.
关键词
结肠癌
急性肠梗阻
单纯结肠造瘘术
肿瘤切除术
Colon cancer
Colon cancer combined with acute intestinal obstruction
Simple colon fistula
Tumor resection