结肠癌伴发急性梗阻的诊断及外科治疗

目的探讨结肠癌伴发急性梗阻的术前诊断和外科治疗问题。方法复习近年有关文献，结合我科近6年中治疗的结肠癌伴梗阻病例的临床资料，对其术前诊断检查和治疗过程进行回顾性分析和总结。结果36例中50岁以上占27冽。右半结肠癌伴急性梗阻16例，左半结肠癌伴急性梗阻20例。本组绝大多数术前确诊靠腹部X线平片和钡剂灌肠。有35例根据肿瘤发生的部位作了Ⅰ期肺切除吻合术，无吻合口瘘的发生。结论对疑为结肠癌引起梗阻的病人，在术前诊断检查上应首选X线腹部平片和钡剂灌肠检查。尽管在急性梗阻时行Ⅰ期结肠切除吻合有发生吻合口疾的危险，但只要掌握好手术适应症，处理好手术的各个环节，Ⅰ期结肠切除吻合术是安全可行的。

Diagnosis and surgical treatment of colon carcinoma with acute obstruction

To investigate the problerns of the preoperative dlagnosis and surgical treatments in colon cancer with acute obstruction. Methods Reviewing recent related documents and clinical materials of patients with obstructing colon cancer hosptialized in our department in the past 6 years, the author retrospectively analyzed the details of preoperative diagnosis and surgical treat ments. Results In the 36 cases with obstructing colon cancer, 27 cases were over 50 years. There were 16 patients with carcinoma of right semicolon and 20 patients with left semicolon. The preopera tive diagnosis in the most patients were identified by abdomen radiograph and barium lavage radio graph. According to the positions of colon tumors, 35 patients were treated by primary resection with anastomosis. There was no occurrence of the fistula. Conclusion The exarninations of abdomen ra diograph and barium lavage image should be selected precedently for patients suspected to be colon cancer with acute obstruction,Though colon cancer with acute obstrucion is often associated with the fistu1a occurrence,it is safe and practical if the surgeon pays attention to the indication of the opera tion and to every step of operative procedure.