结肠癌致肠梗阻的外科治疗（附64例报告）

目的：探讨结肠癌致肠梗阻的外科治疗方法及效果。方法：外科手术治疗结肠癌致肠梗阻64例，其中右半结肠癌并梗阻43例，左半结肠癌并梗阻21例。肿瘤切除一期行肠吻合52例（81．2％）；行肿瘤切除、一期肠吻合、同时行近端结肠预防性造口8例（12．5％），其中4例（6．25％）分别于术后8～12周行造口关闭；4例（6．25％）肿瘤无法切除仅行乙状结肠或横结肠造口。结果：本组64例均治愈。术后出现并发症6例（9．3％），1例为切口感染，3例切口裂开，2例肺部感染，分别采用换药、减张缝合、抗感染等方法治愈。无围手术期死亡。结论：重视结肠癌致肠梗阻的围手术期处理，选择合理的手术方式是提高疗效，减少并发症的重要保证。

The Surgical Treatment of Obstructive Colorectal Carcinoma: A Report of 64 Cases

Objective:To explore the surgical managements for obstructive colorectal carcinoma.Methods:64 patients included 43 cases with obstructive right hemicolon cancer,and 21 with obstructive left hemicolon cancer.Among them,52 cases(81.2%) received primary hemicolectomy and anastomosis;8(12.5%) received primary hemicolectomy and anastomosis and colostomy,which contained 4 accepted colostomy closure operations after 8 to 12 weeks.Other 4 cases(6.25%) received sigmoid colostomy or transverse colostomy.Results:All the patients (64 cases) were cured. The rate of postoperative complications was 9.3% (6 cases).1 case happened incision infection,3 appeared dehiscence of incision,and 2 occurred lung infections.These patients were cured by using dressing changes, reducing suture,and antinfection. No patient died perioperatively.Conclusion:For the patients with obstructive colorectal carcinoma,the proper perioperative management and appropriate choice of surgical procedures are critical to reduce complications and enhance the curative effects.