对不同部位结肠癌性肠梗阻术式选择的临床研究

目的探讨不同部位结肠癌性肠梗阻的术式选择。方法回顾性分析我院2007年7月至2012年12月期间手术治疗76例结肠癌性肠梗阻的临床资料。结果Ⅰ期肿瘤切除60例,占78.9%(60/76),其中Ⅰ期吻合55例,占91.7%(55/60)。左半结肠癌占60%(33/55),其中Ⅰ期左半结肠切除吻合术51.5%(17/33),I期扩大右半结肠切除吻合术27.3%(9/33),经内镜支架置入过渡后行I期左半结肠切除吻合术18.2%(6/33);Hartmann手术5例,占6.5%(5/76),Ⅰ期单纯造瘘9例(5例Ⅱ期切除),总切除率78.9%(60/76),术后并发吻合口漏1例,治愈75例,住院死亡1例(1.3%)。结论对结肠癌急性结肠梗阻应综合分析,选择适当术式,个体化治疗。

Clinical research of surgical procedures for different sites of obstructive colon cancer

Objective To explore the surgical procedures for different sites of obstructive colon cancer. Methods A retrospective analysis was conducted and clinical data from 2007 July to 2012 December in the treatment of 76 cases of obstructive colon cancer in our hospital was combined. Results Sixty patients with colon carcinoma obstruction underwent primary resection, accounting for 78.9%（60/76）. And fifty-five patients finished anastomosis, accounting for 91.7%. Left half colon cancer accounted for 60% （33/55）, with 17/33 （51.5%） one-stage left colectomy and anastomosis, 9/33 127. 3%） stage I extended right hemicolectomy for colonic resection and anastomosis, 6/33 （18.2 %） endoscopic stenting of transition period after stage 1 left colon resection and anastomosis. Five patients （5/76） were performed Hartmann operation, accounting for 6.5%. Colostomy underwent in 9 cases （5 cases of second stage Ⅱ resection ）, and the total resection rate was 78.9% （60/76）. One patients developed postoperative anastomotic leakage. Seventy-five patients with obstructive colon cancer were cured, and 1 patients （1.30% ） died in the hospital. Conclusion Colon carcinoma with acute colon obstruction should be comprehensively analyzed and select appropriate operation procedure and individualized therapy.