大肠癌致肠梗阻的外科治疗(附40例报告)

目的:探讨大肠癌致急性肠梗阻的处理方法.方法:分析我院1990-2000年间40例大肠癌致肠梗阻的外科治疗临床资料.结果:40例病人,结肠癌28例,直肠癌12例,中晚期病例占92.5%,Ⅰ期行右半结肠切除10例;Ⅰ期左半结肠切除8例,Ⅰ期行左半结肠或直肠上段癌切除,近端结肠造口,远端肠管闭合备Ⅱ期吻合19例;肿瘤无法切除行乙状结肠造口3例(直肠癌).围手术期死亡率5.0%(2/40).结论:提高对大肠癌肠梗阻的认识,降低误诊率,合理选择术式,做好围手术期的处理,是减少并发症、提高疗效的重要措施.

SURGICAL TREATMENT OF LARGE BOWEL OBSTRUCTION CAUSED BY COLORECTAL CARCINOMA (A REPORT OF 40 CASES)

Objective To study the surgical treatment of large bowel obstruction caused by colorectal carcinoma. Methods Retrospective analysis of the experience of surgical treatment for the large bowel obstruction caused by colorectal carcinoma in 40 patient from 1990 to 2000 was perfomed. Results In the 40 patients,among these patients,28 had colon cancer and 12 rectal cancer. There was 92.5% of these cancers was perfomed in 10 patients, left hemicolectomy was perfomed in 8 patients, left hemicolectomy with proximal colon fistulization was perfomed in 19 patients, sigmoid fistulization was perfomed in 3 patients for their rectum carcinoma couldn't be resected. The perioperative mortality rate was 5.0%(2/40).Conclusion More attention should be paid to large bowel obstruction caused by colorectal carcinoma. Selecting rational colectomy and appropriate perioperative management is important for reducing both complication and mortalit rate.