高龄梗阻性大肠癌38例手术治疗体会

目的探讨高龄大肠癌梗阻的手术处理方法。方法回顾性分析1997～2007年我院收治的38例高龄大肠癌梗阻患者外科治疗的临床资料。结果38例患者一期大肠癌切除吻合24例：分期手术切除吻合12例,其中Hartmann手术9例,3例作结肠造瘘,术后4周再次手术切除吻合;2例姑息手术。术后吻合口瘘发生2例（8.2%）,切口感染3例（8.3%）,围手术期死亡1例（2.6%）。结论重视对高龄更阻性大肠癌的认识,做好围手术期处理,合理掌握手术时机和选择手术方式,是减少并发症、提高疗效的重要措施。

Surgical treatment for carcinomatous colonic obstruction in 38 cases of advanced age

Objective To probe into the surgical treatment for carcinomatous colonic obstruction of advanced age.Methods The surgery treatment datas of carcinomatons colonic obstruction in 38 patients from 1997 to 2007 were analyzed retrospectively.Results Among the 38 cases,stage Ⅰ resection and anastomosis were 24 cases.Hartmann＇s prosedure were 9 cases.3 cases underwent colostomy,and tumor excision anastomosis 4 weeks later.2 cases conldn＇t undergo excision.There were 2 cases with anastomotic stoma leak（8.3%）.1 case died after operation（2.6%）.Conclusion More attention should be paid to the carcinomatous colonic obstruction,and perioperative managements could decease the complications and improve the curative effect.