左半结直肠癌致急性肠梗阻的急诊治疗策略

目的探讨左半结、直肠癌致急性肠梗阻的急诊治疗策略。方法回顾性分析2000-2006年哈尔滨医科大学附属第一医院收治的36例左半结、直肠癌致急性肠梗阻的病例资料。结果行一期肠切除吻合27例,行姑息性结肠造口4例,另5例经肛门插入型肠梗阻导管减压去污后行一期手术。术后切口感染2例,无吻合口漏发生,无手术死亡病例。结论左半结、直肠癌致急性肠梗阻的急诊治疗中,对于选择性病人,一期肠切除吻合术是安全可行的;经肛门插入型肠梗阻导管结肠减压、灌洗去污是对一期肠切除吻合术的有效补充。

Strategy for the emergency management of acute obstruction result from left colon cancer

Objective To investigate the strategy for the emergency management of acute obstruction result from left colorectal cancer.Methods The clinical data of 36 cases of acute obstruction result from left colorectal cancer admitted between 2000 and 2006 in the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively.Results One-stage resection and primary anastomsis was performed in 27 cases.Palliative colostomy was perfomed in 4 cases.Decompression and decontamination by transanal ileus tube and then primary anastomosis were performed in other 5 cases.Wound infection occurred in 2 cases as a surgical complication and no anastomotic leakage appeared.There was no surgical death in the cases.Conclusion For the emergency management of acute obstruction result from left colorectal cancer,one-stage resection and primary anastomosis are feasible and safety in selected cases.Decompression and decontamination by transanal ileus tube is an effective complement for one-stage resection and primary anastomosis.