左半结肠癌并急性肠梗阻16例一期切除治疗体会

目的 探讨左半结肠癌并急性肠梗阻一期切除吻合术的安全性及临床应用体会。方法 回顾分析2008年7月至2011年5月我科收治的左侧结肠癌并急性肠梗阻16例患者的临床资料。所有患者应用术中结肠减压灌洗并一期切除吻合，结合术后应用抗生素及全胃肠外营养等综合治疗。结果 16例患者中，行一期根治性切除吻合术15例，姑息性切除1例。所有患者全部治愈，无吻合口瘘，腹腔脓肿等并发症发生，仅一例发生术后切口感染，经换药治疗痊愈。结论 正确把握手术适应症，术中有效地的肠道灌洗，重视围术期综合治疗，左半结肠癌致急性肠梗阻患者行一期根治性切除吻合是一种安全可行的手术方式，值得临床应用推广。

Experience of one stage resection for treating left colon cancer associated with acute obstruction in 16 cases

Objective To investigate the safety of one stage resection for treating left colon cancer associated with acute obstruction.Methods From July 2008 to May 2011,the clinical data of 16 cases with left colon cancer associated with acute obstruction were analyzed retrospectively.The patients were anderwnet intraoperative colonic decom-pression and colonic lavage in one-stage resection and anastomosis.The antibiotics and parenteral nutrition were used before and after operation.Results Of 16 cases,15 underwent one stae radical resection and anastomosis,and one case received palliative resection.No anastomotic leakage and abdominal abscess were found after operation.Postoperative wound infection occurred only in one case and via change dressing,the wound was healed by change clressing.Conclusion Correct griping operation indication,efficientively intraoperative intestinal lavage and reasonable perioperative treatment are important method for left colon cancer associated with acute obstruction when receiving one stage resection and anastomosis.