结肠癌并发急性肠梗阻的外科治疗  

Surgical management of obstructive colorectal carcinoma

作　　者：彭爱国[1] 金小顺[1] 赵怀辉[1] 

机构地区：[1]滁州市第一人民医院普外科,239000

出　　处：《安徽医学》2010年第6期610-611,共2页Anhui Medical Journal

摘　　要：目的探讨结肠癌并发急性肠梗阻的外科治疗方法及效果。方法回顾性分析64例结肠癌并发急性肠梗阻行急诊手术治疗者的临床资料,其中右半结肠癌并发梗阻21例,左半结肠癌和直肠癌并梗阻43例。结果 64例均行手术治疗,其中行Ⅰ期切除吻合44例(右半结肠Ⅰ期切除吻合21例,左半结肠直肠Ⅰ期切除吻合23例)。术后发生吻合口瘘1例,肺部感染3例,伤口感染7例,切口裂开1例,总并发症发生率为17.2%,除2例死于多器官衰竭外,其他病例均通过非手术治疗痊愈,随访统计1,3,5年生存率分别为98.2%,52.5%,35.7%。结论Ⅰ期切除吻合手术治疗结肠癌并梗阻是可行的,而合理地选择手术方式,正确的术中操作和围手术期处理,对提高疗效,改善患者生活质量有所裨益。Objective To explore the effect of surgical management of obstructive colorectal carcinoma.Methods A restrospective analysis was made on the clinical data of 76 cases of acute obstructive colorectal carcinoma treated by emergent operation in Chuzhou First People＇s Hospital from October 1996 to December 2008.Among the 64 cases,there were 21 cases of right colon obstruction and 43 cases of left colon or rectal obstruction.Results All the 64 patients received operation,44 patients received one stage tumor resection and large interstinal anastomosis,including 21 in right colon and 23 in left colon or rectal obstruction.Postoperative complications rate was 17.2%（11/64） in this series,including anastomotic leakage in 1,disruption of wound in 1,infection of incisional wound in 7,and pneumonia in 2 cases.Only two patients died of MSOF,the others were cured by non-operation therapy.The postoperative 1,3,5 year survival rates were 98.2%.52.5%,35.7% in this series.Conclusion One stage resection and anastomosis is a feasible operation for obstructive colorectal carcinoma.Appropriate choice of the operative procedure,skillful operative technique,and prudential perioperative treatment can enhance the cuerative effect and the patients quality of life.

关 键 词：结直肠肿瘤/并发症 肠梗阻/病因学 肠梗阻/外科学 

分 类 号：R735.35[医药卫生—肿瘤]