左半结肠癌伴梗阻患者期手术、不同引流方法的临床对比观察  

Study of Different Drainage on Emergency Left Colon Resection with Primary Anastomosis for Obstructing Carcinoma of the Left Colon

作　　者：胡世雄[1] 吴印爱[1] 刘军[1] 刘献棠[1] 郑镇木[1] 

机构地区：[1]解放军第157医院普外科,510510

出　　处：《实用癌症杂志》2006年第1期77-78,共2页The Practical Journal of Cancer

摘　　要：目的探讨预防和减少左半结肠癌伴梗阻期切除吻合术后吻合口漏发生的新方法。方法将181例左半结肠癌梗阻患者,按术中结肠灌洗和期切除吻合等处理方法分为3个组:扩肛组(A组),单管引流组(B组)和双管引流组(C组)。对3个组患者术后吻合口漏发生率进行对比分析。结果术后吻口漏发生率双管引流组、单管引流组、扩肛组分别为3.2%(2/62)、16.7%(10/60)、18.7%(11/59)。双管引流组分别与单管引流组、扩肛组两组吻合口漏发生率比较均有显著性差异(P<0.05)。结论肠腔内双管引流法具有预防性结肠“内造瘘”、减压减张、冲洗洁净和持续性扩肛作用,能有效地预防和减少左半结肠癌伴梗阻期切除吻合术后吻合口漏的发生。Objective To investigate the new methods of preventing anastomotic leakage after emergency left colon resection with primary anastomosis for obstructing carcinoma of the left colon. Methods 181 patients with obstructing carcinoma of the left colon were allocated to three groups, each underwent emergency left colon re.section with primary anastomosis and on-table colonic irrigation. In the group C, two tubes were placed at the anastomoticproximal and distal in the colonic cavity. In the group B,just one tube. In the groupA, Postoperatively patients were taken only the anal dilation regularly. The postoperative complications of three groups were compared.Results There were 11（18.7%） anastomotic leaks in the group A and 10（16.7） In the group B, in the group C,2（3.2% ） anastomotic leaks occurred. The incidence of anastomotic leak in the group A and B were statistically higher than that in the group C（P 〈 0,05）. Conclusion We believe that drainage by two tubes in the colonic cavity can effectively prevent anastomotic leak after emergency resection of left colon with primary anastomosis for obstructing carcinoma of the left colon.

关 键 词：左半结肠癌 梗阻 期切除吻合术 术后并发症 引流 

分 类 号：R735.35[医药卫生—肿瘤]