手术治疗57例老年结肠癌并肠梗阻的临床研究

目的探讨老年结肠癌并肠梗阻的外科手术治疗措施。方法回顾性分析57例年龄在60岁以上的老年人结肠癌并发急性梗阻的外科诊断和治疗资料。结果57例病人中,47例急诊手术,I期切除吻合35例;2例行回肠-横结肠吻合;10例行单纯肠造瘘。术后吻合口瘘2例,死亡1例。限期手术10例,术后无吻合口瘘及死亡发生。结论老年人结肠癌并发急性肠梗阻,经非手术治疗缓解者,限期手术疗效较好;需急诊手术者,及时明确诊断,尽早手术,综合实际情况合理选择术式,做好术后处理,是提高疗效的关键。

Clinical Research on the Operation Treatment for 57 Cases with Obstructive Colorectal Cancer and Intestinal Obstruction in the Elderly

Objective To explore the effect of surgical treatment measures for colorectal cancer and intestinal obstruction in the elderly.Methods A retrospective analysis was made on the clinical data of 57 cases with acute obstructive and colorectal carcinoma in the elderly.Results Among the 57 cases,there were 47 cases treated by emergent operation,and 35 patients were performed with primary resection and anastomosis.2 cases were performed with ileum-transverse colon anastomosis.10 cases were performed with simple intestinal fistulization.2 cases had anastomotic leakage and 1 case was dead.10 cases were performed with limited operation and no case had anastomotic leakage or died.Conclusion In the acute colonic obstruction caused by colorectal carcinoma in the elderly,the cases whose patient's condition are relieved through non-operation treatment,can be gotten satisfactory curative effect by limited operation.The cases should be treated with following measures:diagnosing and operating in time;choosing operative manner on the basis of patient's general situation;location and local situation of carcinoma;consummate postoperative treatment.