左半结肠癌伴梗阻128例分析

分析左半结肠癌伴梗阻１２８例，其中部分梗阻７１例，完全梗阻５７例。两种梗阻从病理类型上差别不大，但完全梗阻病例Ｄｕｋｅｓ分期较晚，肿瘤切除机会少，死亡率高。对左半结肠癌疑有部分性梗阻者，应禁用泻剂，并注意灌肠方法；入院后应禁止粗纤维食物，而进食流质或禁食，以防止部分梗阻转变为完全性梗阻。为防止急性梗阻的闭襻性结肠发生穿孔，对完全性梗阻者应积极纠正水电解质紊乱和休克，一旦全身情况稳定即应手术。同时讨论了处理部分性和完全性左半结肠癌伴梗阻的几种术式，认为术中结肠灌洗是对左半结肠癌伴梗阻进行急诊处理的一个好方法

INTESTINAL OBSTRUCTION DUE TO CARCINOMA OF LEFT HEMICOLON(ANALYSIS OF 128 CASES)

One hundred and twenty eight patients with intestinal obstruction due to cancer of left lemicolon are presented. In this series 71 patients suffered from partial intestinal obstruction and 57 patients from complete obstruction, the latter were in later Dukes stages, with lesser resectability of the tumor and higher mortality. The transition from partial obstruction to complete obstruction takes a slow course. Purgatives and coarse fibered food should not be given to the patients with partial obstruction, or else will induce acute obstruction. Several types of operation for partial and complete obstruction are discussed. Methods and results of intraoperative colonic irrigation are presented. The authors believe that intraoperative colonic irrigation is a good emergency management for cancer obstruction of the left colon. Complication of this disease are also discussed.