老年结肠癌肠梗阻患者术中处理及一期吻合的探讨  

On-table irrigation and one-stage anastomosis for emergency obstructive in elderly colon cancer patients

作　　者：李俊生[1] 张亚男[1] 陈卫东[1] 鞠兴唐[1] 汤文浩[1] 

机构地区：[1]东南大学附属中大医院普外科,南京210009

出　　处：《临床肿瘤学杂志》2007年第8期606-608,共3页Chinese Clinical Oncology

摘　　要：目的:探讨老年患者结肠癌合并肠梗阻的急诊手术方式及术中处理方法。方法:对我科近3年来的32例老年结肠癌合并肠梗阻的患者(左半结肠18例,右半结肠14例)的一期吻合者进行分析。32例患者进行一期术中肠道灌洗,一期吻合,对术中污染重者,予以切口敞开,术后再次缝合。结果:所有一期吻合的患者均无吻合口瘘发生,痊愈出院,左半结肠与右半结肠梗阻在围手术期并发症上无明显差异,切口三期缝合可以缩短切口愈合时间。结论:恰当地选择适合的病例,左半结肠合并肠梗阻者可以同右半结肠一样,进行肿瘤切除后一期吻合。Objective：To investigate the management of colon obstruction of cancer. Methods：Thirty-two elderly cases of bowel obstruction caused by colon cancers were recruited during the past three years, among them, 18 tumors located in the left side of colon, while, 14 in right side of colon, all of them were treated with intraoperative decompression, on-table lavage, resection and ananstomosis. Concerning the heavy contamination during operation, 5 wound were left open and changed dressing for after 4-5 days for ternary closure. Results：There was no anastomotic leakage observed, all patients discharged without motality, there were no significant difference in the postoperative complications between right and left side bowel obstruction, and ternary wound closure shorted the wound healing duration. Conclusion：Primary resection and anantomosis is acceptable for emergency colonic obstruction both for left and right sides in elderly colon cancer patients.

关 键 词：结肠癌 肠梗阻 术中灌洗 一期吻合 

分 类 号：R735.35[医药卫生—肿瘤]