结直肠癌并发急性肠梗阻83例外科治疗分析

目的分析结直肠癌并发急性肠梗阻的外科治疗方法。方法回顾性分析2002年1月～2012年1月间收治的83例患者的临床资料。结果行一期切除吻合68例，行分期手术4例，行一期造瘘、二期肿瘤切除肠吻合2例，行姑息性造瘘9例。围手术期无死亡病例出现，术后发生切口感染6例，肺部感染4例，吻合口瘘1例，切口裂开1例，腹腔包裹性积液1例，经抗感染、加强引流、换药、穿刺引流等对症处理后痊愈。结论在掌握适应证的情况下，行一期切除吻合安全可行，可作为首选治疗方法，同时积极防治吻合口瘘是提高一期手术疗效的重要措施。

Observation on surgical treatment of acute intestinal obstruction caused by colorectal cancer

Objective To observe the surgical treatment of acute intestinal obstruction caused by colorectal cancer. Methods A total of 83 cases of colorectal cancer from Jan 2002 to Jan 2012 was analyzed retrospectively. Results All patients received operation. 68 cases were treated by stage-I operation, 4 cases by staging operation, 2 cases by stage-II operation and 9 cases by proximal intestinal fistulization. There was no perioperative death. Postoperative complication including wound infection in 6 cases, pulmonary infection in 4 cases, anastomotic leak in 1 case, wound split in 1 case and encapsulated effusion in 1 case, all complications were cured by conservative treatment. Conclusion It is safe and feasible to operate stage-I anastomosis with the control of indicatio, it can be the preferred method. Meanwhile, to prevent and cure the anastomotic leak is a important measure to inhance the effect of staze-I anastomosis.