左半结肠癌梗阻外科治疗的有关问题探讨

目的探讨左半结肠癌梗阻外科治疗的有关问题。方法回顾性分析20年间行外科治疗的78例左半结肠癌梗阻病人的临床资料。结果Ⅰ期切除吻合术后灌洗造瘘组（16例）和非灌洗组（14例）切口感染的发生率分别为18．8％和143％（P〉0.05），吻合口漏的发生率分别为6．3％和7．1％（P〉0．05），营养组（8例）无切口感染和吻合口漏发生。结论不应把灌洗造瘘作为提高左半结肠癌梗阻Ⅰ期切除吻合术手术安全性的首遗方法，术后早期营养支持和恰当的手术方式同样重要。

Study of some problems about surgical treatment of acute obstruction of left colon carcinoma

[Objective] To study some problems about the surgical treatment of acute obstruction of left colon carcinoma. [Methods] The data of 78 patients with acute obstruction of left colon carcinoma received surgical treatment during 20 years were analyzed retrospectively. [Results] After one stage resection and anastomosis, the rate of anastomotic leakage in irrigation plus temporary colostomy group and in non-irrigation group was 6.3% and 7.1%, the rate of wound infection was 18.8% and 14.3% respectively, no anastomotic leakage and wound infection occurred in feeding group. [Conclusion] We should not take the irrigation plus temporary colostomy as the first choice method for the operative safety. Early postoperative feeding and proper operation are also important.