结肠次全切除术与术中灌洗一期吻合术治疗左半结肠癌致肠梗阻的对比分析  

The comparison of subtotal colectomy and primary anastomosis after intraoperative colonic irrigation for obstructing carcinoma of the left colon

作　　者：舒旭波[1] 

机构地区：[1]怀化市溆浦县人民医院普外科,湖南怀化419315

出　　处：《临床和实验医学杂志》2008年第6期21-22,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨左半结肠癌致肠梗阻行结肠次全切除术(SC)和术中灌洗一期吻合术(ICI)的临床意义。方法对比分析采用结肠次全切除术(SC组,27例)和术中灌洗一期吻合术(ICI组,28例)治疗左半结肠癌致肠梗阻病人的疗效。结果手术时间SC组明显短于ICI组,SC组发生切口感染5例(18.5%)。吻合口漏2例(7.41%)。ICI组发生切口感染4例(14.3%),吻合口漏3例(10.7%),两组均无1例死亡。并发症发生率、平均住院时间及术后5年存活率两组均差异无显著性(P>0.05)。结论急诊手术为左半结肠癌致肠梗阻处理的首选,结肠次全切除术及术中灌洗一期吻合术均为有效的处理方法,但手术方式的选择应具体情况具体分析。Objective To investigate the clinical value of subtotal colectomy （SC） and primary anastomosis after intraoperative colonic irrigation （ICI） for obstructing carcinoma of left colon. Methods Fifty five patients were divided into subtotal colectomy group （28 patients, SC group） and primary anastomosis with intraoperative colonic irrigation group （27 patients, ICI group）, The efficacy of SC and ICI was compared. Results Mean operating time was significantly shorter SC group than that in ICI group. The infection rate of wound was 18.5% in SC group and 14.3% in ICI group, No patient died in both groups. No differences were found in the surgical complication rate, average stay in hospital and 5 years survival rate in both groups （ P 〉 0.05 ）. Conclusion Subtotal colectomy and primary anastomosis after intraoperative colonic irrigation are effective methods for management of obstructing carcinoma in the left colon. The selection of an effective technique should be depends on the analysis of the practical situations.

关 键 词：左半结肠癌 肠梗阻 结肠次全切除术 术中灌洗术 一期吻合术 

分 类 号：R735.35[医药卫生—肿瘤] R574.2[医药卫生—临床医学]