左半结肠及直肠癌并急性肠梗阻46例外科治疗

目的 探讨左半结肠及直肠癌并急性肠梗阻的合理外科治疗方法.方法 回顾性分析1999-2009年我院收治的全部46例左半结肠癌及直肠癌并急性肠梗阻行外科治疗的病例资料.结果 行一期肠切除吻合术30例,行一期根治性切除肿瘤、Hartmann 结肠造口术、二期闭瘘术7例,经保守治疗及经肛门导管结肠灌洗减压后行一期手术4例,行姑息性结肠造口术5例.术后切口感染5例,吻合口漏1例.无手术死亡病例.结论 左半结肠及直肠癌并急性肠梗阻的外科治疗,如进行合适的术前准备及术中处理,一期肠切除吻合术是安全可行的.

Surgical management of acute obstruction caused by left colorectal cancer in 46 cases

Objective To investigate the reasonable surgical method for acute obstruction caused by left colorectal cancer.Methods The clinical data of 46 cases of acute obstruction caused by left colorectal cancer admitted between 1999 and 2009 in our hospital were analyzed retrospectively.Results One-stage resection and anastomosis was performed in 30 cases.One-stage tumor resection and Hartmann operation was performed in 7 cases,decompression and decontamination by transanal ileus tube and then primary anastomosis was performed in 4 cases. Palliative colostomy was performed in 5 cases.Wound infection occurred in 5 cases as a surgical complication and anastomotic leakage occurred in 1 case.There was no surgical death in the cases.Conclusions For the surgical management of acute obstruction caused by left colorectal cancer,one-stage resection and primary anastomosis is fea-sible and safe with reasonable preoperative preparation and intraoperative treatment.