左半结肠、直肠癌合并急性梗阻的外科治疗  

Surgical treatment for acute obstruction due to carcinoma of the left colon and rectum

作　　者：周伟[1] 黄林平[1] 王正康[1] 韦佳明[1] 

机构地区：[1]中日友好医院普外一科,北京100029

出　　处：《中日友好医院学报》2009年第4期201-204,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨左半结肠、直肠癌合并急性梗阻患者的安全、有效的治疗方法。方法:分析中日友好医院普外科收治的31例左半结肠、直肠癌合并急性梗阻的手术资料,其中采用术中结肠灌洗、一期切除吻合16例,Hartmann手术6例,一期横结肠造口、二期切除肿瘤吻合、同时造口关闭4例,结肠次全切除1例,先置肛管减压再行根治切除1例,肿瘤未能切除采用永久肠造口或肠捷径3例。结果:本组围手术期无死亡。术后共发生吻合口漏3例,均经非手术治疗治愈,合并切口感染4例。结论:术中结肠灌洗一期切除吻合是左半结肠、直肠癌合并急性梗阻的首选手术方法,但应根据患者的实际情况选择最适当的治疗方法。Objective：To clarify the safe and effective treatment methods for the patients with acute obstruction of the left hemicolon cancer and rectum cancer.Methods：Analysis of thirty-one patients with acute obstruction of the left coloreetal carcinoma underwent surgical therapy in the department of surgery,China-Japan Friendship Hospital,including sixteen cases underwent one-stage resection and anastomosis after intraoperative colonic irrigation （ICI）,six cases underwent Hartmann＇s operation＇s,four cases underwent staging operation,one case using subtotal colectomy,one case underwent Miles＇operation after preoperative decompression,three cases whose tumour couldn＇t resect underwent perpetual colostomy and by-pass.Results：There was no perioperative mortality.Three cases had anastomotic leak postoperatively,which healed by conservative treatment.Infection of incision wound occurred in four cases.Conclusion：It is first selection to perform one-stage resection and anastomosis for acute obstruction of the left colorectal carcinoma after ICI, but the most suitable treatment methods is selected according to the actual disease condition.

关 键 词：结直肠癌 肠梗阻 术中结肠灌洗 一期手术 治疗方法 

分 类 号：R735.3[医药卫生—肿瘤]