大肠癌并发急性肠梗阻外科治疗97例临床分析

目的 探讨大肠癌并发急性肠梗阻的外科治疗方法。方法总结97例大肠癌并发急性肠梗阻行手术治疗患者的临床资料。结果左半结肠癌并发梗阻37例，其中2例结肠癌并梗阻导致穿孔（横结肠近脾区1例、乙状结肠1例）；右半结肠癌并梗阻41例；直肠癌并梗阻19例。一期切除吻合75例，Hartmamm手术11例，回肠乙状结肠或回肠直肠捷径吻合手术5例，肿瘤切除、近端肠管造口、二期恢复肠道连续6例。术后出现并发症15例（15．4％），包括：切口感染、腹腔脓肿和肠瘘。死亡1例，96例（98．9％）痊愈出院。结论经阑尾残端行结肠灌洗并一期切除吻合治疗大肠癌并发肠梗阻，方便可行、安全有效。

Analyses of carcinoma of large intestine complicated with acute intestinal ObstructiOn

Objective To explore the surgical effects of carcinoma of large intestine complicated with acute intestinal obstruction. Methods The clinical data of 97 patients with carcinoma of large intestine complicated with acute intestinal obstruction undergoing emergency operation were summarized. Results There were 37, 41 and 19 patients with carcinoma of large intestine complicated with acute intestinal obstruction on left hemicolon, right hemicolon and rectum, respectively. 75 cases were operated with onestage operation, li cases with Hartmann operation and 6 cases with tumor resection, sigmoidostomy and intestinal continuity. Postoperative complications occurred in 15 cases （15.4M）, including incision infection, intraperitoneal infection and intestinal fistula. 96 cases healed （98.9%）, whereas 1 case died. Conclusion Tumor resection and anastomosis after colonic irrigation through the appendix stump in onestage are feasible and safe for carcinoma of large intestine complicated with acute intestinal obstruction.