结直肠癌伴急性梗阻48例的外科治疗

目的: 探讨结直肠癌伴急性梗阻的术式选择。方法: 回顾分析48例结直肠癌伴急性梗阻患者的临床资料。其中,行一期肿瘤切除吻合术24例,一期肿瘤切除吻合口外置术或Hartmann术16例,捷径手术或双腔造口术8例。结果: 术后22例出现并发症,其中肺部感染10例,切口感染8例,腹腔感染2例,切口裂开2例。4例病死,围手术期病死率为8.3%,余44例均痊愈出院。结论: 病情允许时,应当一期切除肿瘤行肠吻合术,积极的术前准备和术后处理、合理的手术方式对减少并发症、降低病死率有重要意义。

Surgical treatment of 48 patients with acute intestinal obstruction and colorectal carcinoma

Objective:To investigate the proper operation method for colorectal carcinoma associated with acute intestinal obstruction.Methods:The clinical data of 48 patients with colorectal carcinoma associated with acute intestinal obstruction undergoing the surgical treatment from 1997 to 2006 were retrospectivedly analyzed.Twenty-four patients underwent colectomy with one-stage anastomosis,16 colectomy and the same pluged anastomotic stoma out of peritoneal cavity or Hartmann operation,8 double-cavity colostomy or by-pass.Results:Twenty-two patients experienced postoperative complications (45.8),including lung infection in 10 patients,wound infection in 8,peritoneal cavity infection in 2 and disruption of wound in 2.The perioperative mortality was 8.3 (4/48).Conclusions:Under the probable conditions,colectomy with one-stage anatomasis should be performed first.The active preoperative preparation and intensive postoperative treatment,the correct operation methods are important for reducing morbidity and mortality.