支架植入治疗左半结肠直肠癌所致的急性梗阻

目的：探讨肠道支架放置对左半结肠直肠癌所致的急性梗阻之治疗效果和安全性。方法：对2000年5月～2006年6月收治的42例左半结肠直肠癌所致的急性梗阻进行临时性或姑息性支架放置：观察支架植入后梗阻缓解情况和并发症。结果：42例中34例支架植入成功（81．0％）．24h内的临床梗阻缓解率为94．1％（32／34）．全组无死亡发生。术后并发结肠穿孔和食物残渣堵塞支架各1例，均改作Hartmann手术；支架移位和肛门疼痛各2例。18例经过肠道准备和全身支持治疗后再行根治性手术；另14例支架植入属永久性姑息性治疗。结论：肠道支架植入对左半结肠、直肠癌所致的急性梗阻是一种安全有效的临时过渡性或永久性姑息性治疗手段，可借以免除急诊结肠造瘘术。

Stent implantation in treating acute bowel obstruction caused by left colorectal malignancies

Objective To summarize the safety and efficacy of metallic stent implantation in treating acute bowel obstruction caused by left colorectal malignanies.Methods From May 2000 to June 2006,self-expanding metallic stent(SEMS) was implanted in 42 patients with acute left colorectal obstruction caused by malignancies.Postoperative remission and complications were observed.Results Stents were implanted successfully in 34 cases(81.0%,34/42).The obstruction in 32 out of the 34 cases was released within 24 h.Bowel perforation occurred in one patient and food residue occlusion in another after stent implantation,they were then submitted to Hartmann operation.Elective radical resection was performed after bowel preparation and supportive therapy in the other 18 cases.Conclusions Stent implantation,instead of emergent colostomy,is a safe and effective procedure,either for temporarily relieving the obstruction,or as a part of the permanent treatment for acute left colorectal obstruction caused by malignancies.