左半结肠癌并梗阻Ⅰ期手术切除吻合的治疗体会

目的：探讨左半结肠癌并梗阻Ⅰ期手术切除吻合的治疗方法及围术期处理原则。方法：回顾性分析2005年5月～2010年5月Ⅰ期手术切除吻合左半结肠癌并梗阻患者20例的临床资料。结果：术后19例痊愈出院,无吻合口瘘,其中包括3例并发切口感染;1例放弃治疗,自动出院。结论：左半结肠癌并梗阻Ⅰ期手术切除吻合是比较安全可靠的治疗方法,但是也要严格掌握适应证,术中肠管闭式减压和结肠灌洗、围术期营养支持、高效广谱抗生素的应用、手术技术提高等是预防吻合口瘘的关键。

One-stage resection and primary anastomosis of the left colon cancer with acute obstruction

Objective: To evaluate the treatment and perioperative management of the left colon cancer with acute obstruction. Methods: Clinical data of 20 cases of the left colon cancer with acute obstruction operated upon one-stage resection and primary anastomosis from May 2005 to May 2010 were retrospectively reviewed. Results: All of the 19 cases were cured, there was no leaks. 3 cases occurred incision infection, 1 case gave up. Conclusion: One-stage resection and primary anastomosis of the left colon cancer with acute obstruction is safe, but the indication must be commanded strictly; bowel closed decompression and colonic lavage, perioperation nutritional support, using of efficient broad-spectrum antibiotic, the operation technology improvement are keys to prevent leaks.