梗阻性大肠癌的急诊处理(附138例分析)  

Emergency Management of Obstructing Colorectal Cancer Encl. Analysis of 138 Cases

作　　者：姬社青[1] 花亚伟[1] 徐勇超[1] 张鉴哲[1] 

机构地区：[1]河南省肿瘤医院普外科,河南郑州450008

出　　处：《河南肿瘤学杂志》2004年第4期269-270,共2页Henan Journal of Oncology

摘　　要：目的　探讨结肠癌急性梗阻的诊断和手术方式选择。方法　回顾分析我院 1986— 2 0 0 0年 13 8例梗阻性结直肠癌病人的临床特点及治疗方法。对梗阻性左半结肠癌 ,术中行顺行结肠灌洗或次全结肠切除 ,Ⅰ期切除吻合术 98例 ( 70 %) ,分期手术 2 2例( 16%) ,Miles及Hartmann术 12例。其他手术 10例。结果　手术死亡率为 8.7%( 12 / 13 8) ,吻合口漏发生率 4.5 %,切口感染率 16.2 %,其余病人恢复顺利。结论　对于梗阻性左半结肠癌 ,术中灌洗Ⅰ期吻合和结肠次全切除都是可供选择的方法 。Objective To assess our experience of the management of obstructive colorectal cancer.Methods The treatments of 138 cases with obstructing colorectal cancer were analyzed retrospectively. Of all the cases, primary resection and anastomosis was performed in 98 cases, 34 cases with right sided and 58 left sided, 6 with sigmoid colon cancer. Staged resection was carried out in 22 cases. 12 cases underwent with Hartmann's or Miles' procedure. Primary resection and anastomosis with intraoperative bowel irrigation was performed in 30 patients. Results Overall mortality rate was 8.9% for all resected patients and anastomotic leakage rate 4.5%, wound infection rate 16.2%. The 5 year survival rate was 42.9% after primary and 27.5% after staged resection. Conclusions Primary resection and anastomosis with intraoperative irrigation of the colon and subtotal colectomy should be adopted for left sided colorectal cancer. The choice of procedure must be tailored to each patient.

关 键 词：结直肠癌 梗阻 手术 

分 类 号：R735.34[医药卫生—肿瘤]