结肠癌并发急性肠梗阻80例手术治疗效果分析

Analysis of the operation treatment effect of 80 cases of colon cancer combined with acute intestinal obstruction

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.