结直肠癌合并急性肠梗阻的外科治疗

目的探讨结直肠癌并急性肠梗阻病例的外科处理原则和方法。方法回顾性分析我院自2004年至2008年收治的86例结直肠癌并急性肠梗阻病例,结合近年国内,外文献,综合评价其外科处理方法。结果右半结肠梗30例,全部行一期切除吻合术;其余56例低位梗阻患者中38例行一期切除吻合,4例行Miles术,9例行Dixon手术,2例行Hatmann术,2例行单纯遣口术,1例行短路加造口术。术后12例出现并发症,其中肺部感染5例,切口感染5例,腹腔感染2例,切口裂开2例,吻合口瘘1例,均经积极治疗好转出院。死亡2例,病死率为8.3%,其余均痊愈出院。结论结直肠癌并急性结肠梗阻的处理要根据患者的全身情况和肿瘤的局部情况来进行综合判定。适应证掌握恰当。一期肿瘤切除和吻合术是安全的。

Surgical Management of Acute Intestin Obstruction Caused by Colorectal Cance

Objective To evaluate the principle and method of surgical management of acute intestin obstruction caused by colorectal cancer.Methods Data of 86 above cases in our hospital from 2004 to 2008 were analyzed retrospectively.With a review of recent domestic and foreign literatures,surgical management about these patients was comprehensively evaluated.Result Primary resection and anastomosis were performed in 30 cases with right colon carcinoma.Of other 56 cases,38 with left colon carcinoma received primary resection and anastomosis,4 Miles'operation,2 Hartmann operation,1 colostomy,1 colostomy and by-pass oparation.12 patients experienced postoperative complications(14.3%),including lung infection in 5 patients,wound infection in 2,peritoneal cavity infection in 2 and disruption of wound in 2,anastomotic leakage in 1,all patients were cured by active treatmen.2 cases were dead and the mortality rate was 8.3%,The rest of patients were healed.Conclusion The management of acute colon obstruction caused by colorectal cancer depends ongeneral condition of the patient and local manifestation of the cancer.If only an indication is appropriate,the single-stage resection and anastomosis may be safe and suitable.