急诊左半结肠一期切除吻合术25例治疗体会

目的探讨急诊左半结肠切除一期肠吻合的可行性。方法腹腔探查完后，用布带结扎横结肠，游离肠系膜后，于预切除肠段的上端切开作肠外减压，挤压排空粪便，切除病变肠管，端端吻合，术后作肛管扩张，停留肛管引流，胃肠减压。结果全部病人预期痊愈出院，无发生吻合口漏和腹腔污染。结论该法有利于吻合口的愈合，增加左半结肠一期切除吻合的安全性，减少第2次手术痛苦，可推荐为左半结肠急诊切除一期吻合的良好方法。

Emergency left-side hemicolectomy with one-stage anastomosis for acute colonic obstruction (report of 25 cases)

[Objective] To evaluate the feasibility of emergency left-side hemicolectomy with one-stage anastomosis for acute colonic obstruction. [Methods] 25 cases of acute colonic obstruction were treated by emergency left-side hemicolectomy with one-stage anastomosis. The clinical data were reviewed retrospectively. [Results] Overall, there are 13 males and 12 females. from 30 to 75 years old, with average of 63.5 years. Among 25 cases, 3 cases were diagnosised with volvulus of sigmoid, 3 adult megacolon, 10 high-positioned rectal carcinoma, 9 had colonic cacinoma in descending part or splenic flexure. The interval from obstruction onset to operation was 1 or 2 days. Colectomy with one-stage anastomosis was performed, including sigmoidectomy and coloproctosomy in 15 cases, left-side hemicolectomy and coloproctosomy in 10 cases. All patients healed without postoperative anastomotic leakage and celiac infection. [Conclusion] Emergency left-sided hemicolectomy with one-stage anastomosis is safe and effective for patients with acute colonic obstruction.