高龄梗阻性结肠癌的外科治疗探讨--附61例临床分析

目的：探讨老年梗阻性结肠癌的外科治疗。方法：将手术治疗61例高龄梗阻性结肠癌临床资料作回顾性分析。结果：27例行Ⅰ期右半结肠切除术，16例行Ⅰ期左半结肠切除，11例行Ⅰ期乙状结肠或直肠上段切除，4例行Hartmann手术，2例行结肠造1：3，1例行捷径手术。发生术后并发症47例次，吻合口瘘2例；死亡3例，死亡率4．9％。结论：掌握好适应症高龄梗阻性结肠癌1期切除吻合是安全的，而围手术期处理是保证手术成功的关键。

Management of Colon Obstruction Caused by Colon Cancer in Elderly Patients: a Review of 61 Cases

Objective: To analyze the surgical management of obstructing colon cancer in elderly patients. Methods: Data of 61 above cases by surgical treatment from 1994 to 1998 were analyzed retrospectively. Results: 27 patients with right colon cancer were resected in one stage, 16 patients with left colon cancer were resected in one stage, 11 patients underwent sigmoidectomy or upper rectectomy, 4 cases underwent Hartmann, 2 cases in cecostomy, 1 case in by-pass operation. 47 instances of postoperative complications were happened. Among them, 2 happened in anastomotic leakages 3 in death, with 4.9% mortality rate. Conclusion:Resection and anastomosis in one stage of obstructing cancer of colon in elderly patients is safe if the indication is appropriate. However, the key to surgical success is proper preopera-tive and postoperative care.