双镜联合治疗急性结直肠癌性梗阻的临床价值

目的:探讨联合使用腹腔镜与内镜治疗急性结直肠癌性梗阻的临床价值.方法:2007年1月至2010年1月采用双镜联合治疗的28例急性结直肠癌性梗阻患者的临床资料进行回顾性分析.结果:28例均在内镜下放置支架成功,成功率为100%.梗阻部位分别为直肠上段癌7例,乙状结肠癌11例,降结肠癌8例,横结肠近脾曲2例.术后1~2天均能解除梗阻,术后5~7天接受腹腔镜手术,其中行根治性切除术26例,Hartmann术2例,术后均恢复顺利,无感染及吻合口漏等并发症发生.结论:双镜联合应用治疗急性结直肠癌性梗阻是一种安全、有效的微创治疗方法,操作简单、经济有效、并发症少,可以显著降低病人的创伤和痛苦,提高病人的生活质量.

Combined Therapy of Endoscopic Decompression and Laparoscopic Surgery for Colorectal Cancer with Acute Bowel Obstruction

Objective： To evaluate the feasibility and clinical value of combined therapy of endoscopic decompression and laparoscopic surgery for colorectal cancer with acute bowel obstruction.Methods： The clinical data of 28 patients with with acute malignant colorectal obstruction treated with endoscopic decompression and laparoscopic surgery from Jan 2007 to Jan 2010 were analysed retrospectively.Results： With the aid of fluoroscopy,28 cases with acute malignant colorectal obstruction were were successfully inserted metal stents,the total technical success rate was（28/28,100%）.Their obstructive sites consisted of upper rectum（n=7）,sigmoid colon（n=11）,descending colon（n=8）,transverse colon（n=2）.28 patients showed relief of obstructive symptoms within 1～2 days,the clinical success rate was 100%（28/28）.Laparoscopic surgical resection was performed after clinical decompression and preoperative bowel preparation after 5～7 days,without complications of anastomotic leakage and intraperitoneal infection.Conclusions： Combined therapy of endoscopic decompression and laparoscopic surgery for colorectal cancer with acute bowel obstruction is effective and safe and well tolerated method,and can obviate colostomy,reduce the patients’ trauma and pain,and increase the patients’ living quality.