结肠癌并发急性肠梗阻的诊治体会

目的：探讨结肠癌并发急性肠梗阻的外科处理。方法：回顾性分析1994年至2001年收治的56例结肠癌并发急性梗阻的外科诊断和治疗资料。结果：56例病人中Ⅰ期切除吻合48例(86％)，其中24例行右半结肠切除术，5例行横结肠切除术。9例行左半结肠切除术。10例行乙状结肠切除术。4例行Hartmann术，2例行I期结肠造瘘、Ⅱ期肿瘤切除肠吻合术。2例行永久性结肠双腔造口术。吻合口瘘2例(3．6％)，死亡2例(3．6％)。结论：充分认识结肠癌急性肠梗阻是晚期结肠癌的表现，及时明确诊断，尽早手术，根据病人的整体情况、癌肿的部位、癌肿的局部情况合理选择术式。做好围手术期处理。可以取得较好疗效。

Diagnosis and treatment of the acute colonic obstruction caused by carcinoma of colon

Objective :To study the surgical treatment of colonic carcinoma complicated by acute colonic obstruction. Methods: Data of 56 cases treated in our hospital from 1994 to 2001 was analysed retrospectively. Results: 48 of all 56 cases were performed primary resection and anastomosis, including 24 right hemicolectomies, 5 resections of transverse colon, 9 left hemicolectomies and 10 sigmoidectomies. 4 cases were performed Hartmann's operation, 2 cases were performed primary colostomy and secondary resection and anastomosis, 2 cases were performed double barrel colostomy. The rate of stomal leak was 3.6%(2/56) and the mortality was 3.6%(2/56). Conclusion: The satisfactory curative effect can be gotten by the following: diagnosing and operating in time ;choosing operative manner on the basis of patient's general situation, location and local situation of carcinoma; consummate perioperative treatment.