左半结肠梗阻一期肠切除吻合的治疗体会

目的探讨总结急性左半结肠梗阻一期肠切除吻合术的结果和治疗经验,为临床急性左半结肠梗阻一期肠切除吻合术提供参考依据。方法回顾性分析左半结肠梗阻行一期肠切除吻合术39例,其中直肠上段癌17例,乙状结肠癌7例,脾曲或近脾曲癌13例,乙状结肠扭转伴坏死2例。术前积极处理,有效的结肠灌法,一期病灶切除,行结肠端端吻合术。结果39例病例中有38例痊愈出院,均未发生吻合口瘘,术后2例切口皮下脂肪液化,3例出现肺部感染,1例术后2 d死于肺部感染,存活5年以上12例。结论要严格掌握适应证,正确手术操作,加强手术后护理,左半结肠急性梗阻行一期肠切除吻合术是安全可靠的。

Experience of one-stage resection and anastomosis for left colonic acute obstruction

Objective To summarize the effect and experience of one-stage resection and anastomosis for left colonic obstruction.Methods A retrospective analysis of 39 cases of left colonic obstruction were treated by one-stage resection and anastomosis,including 17 cases of superior rectum cancer,7 cases of sigmoid colon cancer,13 cases of colon cancer located splenic flexure cancer or nearby,2 cases of sigmoid colon retortion accompany putrescence.Active preoperative disposal,effective intestine lavage, one-stage resection and anastomosis.Results All patients were fully recovered except 1 patient died of coronary heart disease and heart failure,and none anastomosis leakage.Conclusion One-stage resection and anastomosis for left colonic acute obstruction is feasible after strict indicatio and appropriate operative management.