高龄老人结直肠癌致急性肠梗阻的外科治疗

目的探讨高龄老人患结直肠癌并发急性肠梗阻的外科治疗原则及方法。方法分析1995-2004年60岁以上47例结直肠癌致急性肠梗阻的外科治疗资料。结果I期行右半结肠切除14例，I期行横结肠切除10例，I期行左半结肠或直肠上段癌近端结肠造口，关闭远端结肠或直肠备Ⅱ期吻合11例，行双腔造瘘12例；术后并发症32％，围手术期病死率4％。结论重视对高龄老人结直肠癌急性肠梗阻的认识，合理选择手术术式，做好围手术期的准备是减少老人并发症、提高疗效、降低死亡率的重要措施。

Surgical Treatment of Acute Obstructive Colorectal Carcinoma in Elderly Patients

Objective To study the principle and methed of surgical treatment of acute obstructivecolorectal cancer in Elderly Patients.Methods The data on surgical therapeutic strategies in 47 cases of acute obstructive colorectal cancer in Elderly Patients over 67 year old from 1995 to 2004 were analyzed retrospectively. Of which,14 cases underwent primary resection of Right hemicolon; 10 cases to transverse colon resection; 11 cases to primary resection of cancer on Left hemicolon or superior segment of rectum, accompanied with neostomy of sproximal end and closure of distal end of colon; 12 cases to neostomy of double cavity of colon. Results Post - operative complications occurred in 32 percent patients; perioperativ e case fatality is 4 percent. Conclusions More attention should be paid to surgical treatment of acute obstructive colorectal carcinoma in elder patients. Selection of optimal surgical method and perioperative management will contribute to elevate therapeutic effect, decrease complications and fatality of natients.