Right Hemicolectomy and Multivisceral Resection of Right Colon Cancer:A Report of 21 Cases

The long-and short-term outcomes in 21 patients with right colon cancer after right hemicolectomy and multivisceral resection surgery were investigated. Short-term therapeutic effects and long-term survival rate were retrospectively analyzed in patients with right colon cancer. These individuals underwent right hemicolectomy in combination with multivisceral resections including pancreatic head, duodenum, kidney, liver, gallbladder, and abdominal wall at the Department of General Surgery in the Henan Tumor Hospital between January 2003 and August 2014. The patients had an average age of 58.9 years(range: 39–78). Three patients had metastatic invasion only to the duodenum; meanwhile 18 patients had invasion to the duodenum and other adjacent organs. The median survival time was 41 months(95% CI: 6.972–75.028) with one death in the perioperative period. No patients lost follow-up. One-, 3-, and 5-year survival rate was 75%, 56%, and 43%, respectively. It was concluded that indications for surgery should be tightly controlled. Favorable clinical outcomes of right hemicolectomy and multivisceral resection surgery were demonstrated for patients with right colon cancer at the T4 stage.     

肛管减压在直肠癌Hartmann术后盆腔感染的治疗应用

目的探讨Hartmann术后盆腔感染肛管减压中的治疗作用。方法回顾分析自2007年12月至2011年12月间我科直肠癌行Hartmann术式治疗的20例患者临床资料。结果 20例行Hartmann术治疗的直肠癌患者术后出现盆腔感染2例,指诊发现直肠残端瘘,均经直肠残端置引流管充分冲洗引流治愈出院。结论 Hartmann术后因直肠残端瘘致盆腔感染后,通过残端留置引流管持续有效冲洗引流,能够有效地治疗感染。     

经鼻饲管回输胃液对腹部术后胃瘫恢复的促进作用

目的研究胃液回输在胃瘫治疗中的作用。方法将37例胃瘫患者分为对照组(n=19)和胃液回输组(n=18)。对照组采用常规禁食、有效持续胃肠减压、静脉输液以保持水、电解质及酸碱平衡等保守治疗;应用甲氧氯普胺、红霉素、西沙必利、多潘立酮等促胃动力药物治疗;介入下将鼻饲管放置于空肠20～30cm处,使用营养泵经鼻饲管进行肠道内营养治疗。胃液回输组除不给予静脉补充电解质外,在对照组治疗基础上进行经鼻饲管定时胃液回输,在鼻饲管上加1个三通,使鼻饲管和胃液引流袋相连,可经鼻饲泵向空肠内输注营养液或胃液。根据患者日常3餐饮食时间将胃液以100～150mL·h-1的速度经鼻饲管回输至空肠。对比2组治疗效果。结果 2组治疗后10、20、30d血红蛋白、白蛋白及电解质水平均高于治疗前,差别有统计学意义(P<0.05);胃液回输组治疗后10、20、30d血红蛋白、白蛋白及电解质水平均高于对照组,差别有统计学意义(P<0.05)。胃液回输组患者恢复胃动力时间短于对照组,差别有统计学意义(P<0.05)。结论经鼻饲管回输胃液对胃瘫的恢复有促进作用。