结直肠癌并急性肠梗阻外科治疗方法

目的探讨结直肠癌并发急性肠梗阻的外科治疗策略及方法。方法回顾性分析漯河市中心医院2004年1月-2010年11月结直肠癌并发急性肠梗阻行手术治疗患者的临床资料。其中右半结肠癌26例,左半结肠癌33例,乙状结肠癌12例,直肠癌7例。男性49例,女性29例,年龄32～85岁,平均66.2岁,其中60岁以上56例,均因急性肠梗阻入院。结果 78例均行手术治疗,77例治愈出院,其中行一期切除吻合51例（右半结肠一期切除吻合23例,左半结直肠一期切除吻合28例）。术后发生肠瘘3例,切口感染8例,切口裂开2例,1例死于多器官功能衰竭。结论有选择的对结直肠癌并梗阻行一期切除吻合手术是可行的,而选择合理的手术方式,正确的术中操作和围手术处理是提高疗效、改善患者生活质量的重要保证。

Surgical Treatment of Obstructive Colorectal Carcinoma

Objective To explore the surgical strategy and treatment of obstructive colorectal carcinoma.Methods A retrospective analysis was made on the clinical data of 78 cases of acute obstructive colorectal carcinoma treated by emergent operation in Luohe Central Hospital from January 2004 to November 2010.Among them 26 cases were right colon cancer,33 cases were left colon cancer,12 cases were sigmoid colon cancer,7 cases were rectal cancer.Results Among 78 cases,there were 49 males and 29 females.The age ranged from 32 to 85 years with an average of 66.2 years,and 56 cases were over 60 years.All the 78 patients received operation,77 cases were cured,51 patients received one stage tumor resection and large intestinal anastomosis,including 23 cases in right colon and 28 cases in left colon,sigmoid colon or rectal obstruction.Postoperative complication including anastomotic leakage in 3 cases,wound infection in 8 cases,disruption of incision were 2 cases,1 cases died of MODS.Conclusion One stage resection and anastomosis was a feasible operation for selective obstructive colorectal carcinoma.Appropriate choice of the operative procedure,skillful operative technique and prudential perioperative treatment can enhance the curative effect and the patient＇s life quality.