结肠癌并发急性肠梗阻的外科处理

目的　探讨结肠癌并发急性肠梗阻的外科处理。方法　分析 1995～ 2 0 0 3年间 5 3例结肠癌致急性肠梗阻的外科治疗资料。结果　 5 3例患者中Ⅰ期切除吻合 4 7例 (88 6 8% ) ,其中右半结肠 8例。横结肠 4例 ,左半结肠 12例 ,乙状结肠 2 3例。 4例Ⅰ期肿瘤切除 ,结肠造瘘 ,Ⅱ期肠吻合术。 2例行永久性结肠双腔造口术。术后并发症发生率 13 2 % (7/5 3) ,围手术期病死率 1 9% (1/5 3)。结论　重视对结肠癌致肠梗阻的认识 ,及时诊断 ,做好围术期处理 ,合理选择手术方式是减少并发症和提高疗效的关键。

Surgical treatment of the acute colonic obstruction caused by colonic carcinoma

Objective To study the surgical treatment of colonic carcinoma complicated by acute colonic obstruction.Methods Relrospective analysis of the experience of surgical treatment for the large bowel obstruction caused by colonic carcinoma in 53 patients from 1995 to 2003 was performed.Results 47 of 53 cases were performed primary resection and anastomosis,including 8 right hemicolectomies,4 resections of transverse colon,12 left hemicotecomies and 23 sigmoidectomies.4 cases were performed primary resection and colostomy and secondary anastomysis,2 cases were performed double barrel colostomy.The postoperative complication rate was 15.3%(8/53),and percoperative mortality rate was 1.9%(1/53).Conclusion More attention should be paid to large bowel obstruction caused by colonic carcinoma.Diagnosing in time and appropriate perioperative management and selecting rational colectomy is important for reducing bath complication and mortality rate.