左侧结肠癌并急性肠梗阻一期切除吻合的诊治体会

Diagnosis and treatment experience of primary resection and anastomosis of left colon cancer combined with acute intestinal obstruction

目的:探讨左侧结肠癌并急性肠梗阻的一期切除吻合的诊治体会。方法:2013年2月-2014年3月收治左侧结肠癌并急性肠梗阻患者80例,作为研究对象,将其施行一期切除吻合术的临床资料进行回顾性分析。结果:80例结肠癌并急性肠梗阻患者术后无一例死亡,46 h^5 d后开始肛门排气。当腹腔引流液澄清且<20 m L/d时,将引流管拔出,术后8~11 d所有患者拆线。切口感染5例,腹腔感染6例,经过治疗后均痊愈;因合并低蛋白血症而出现吻合口瘘2例,经过肠内外营养支持治疗后痊愈。术后并发症发生率16.25%。结论:把握正确的手术时机行左侧结肠癌并急性肠梗阻一期切除吻合术效果良好,提高了患者的生活质量,并发症发生率低、安全性高,值得临床进一步推广。

Objective:To explore the diagnosis and treatment experience of primary resection and anastomosis of left colon cancer combined with acute intestinal obstruction.Methods:80 patients with left colon cancer combined with acute intestinal obstruction were selected from February 2013 to March 2014.They were as the study object,and the clinical data of primary resection and anastomosis were analyzed retrospectively.Results:There was no one death cases in 80 cases of patients with colon cancer combined with acute intestinal obstruction.They had anal aerofluxus after 46 hours and 5 days.When abdominal drainage fluid was clear and less than 20 m L one day;the drainage tube was pulled out;all patients were taken out stitches after postoperative 8 to11 days.5 cases were incision infection;6 cases were peritoneal infection,and after treatment they were cured.2 cases had anastomotic fistula due to the merger hypoalbuminemia,and they were cured after internal and external nutrition support treatment.The incidence rate of postoperative complication was 16.25%.Conclusion:Grasping the correct operation opportunity of giving primary resection and anastomosis of left colon cancer combined with acute intestinal obstruction has good effect.It improves the life quality of patients.It has low complication incidence rate and high security.It is worthy of further promotion.