直肠癌伴梗阻行Ⅰ期经腹直肠癌切除术的体会  

Treatment effect of single-stage Dixon radical operation in rectal cancer with obstruction

作　　者：徐怀文 牛跃平[1] 高健[1] 董峰[1] 王瀚[1] Huai-wen Xu Yue-ping Niu Jian Gao Feng Dong Han Wang(Department of General Surgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450014, China)

机构地区：[1]郑州大学第二附属医院普外科,河南郑州450014

出　　处：《中国现代医学杂志》2016年第24期83-85,共3页China Journal of Modern Medicine

基　　金：河南省高等学校重点科研项目(No:16A320018)

摘　　要：目的探讨直肠癌伴梗阻患者行I期经腹直肠癌切除术(Dixon手术)的效果。方法选取实施I期Dixon手术的87例直肠癌伴梗阻患者为研究对象,分为观察组(急诊手术行结肠灌洗)51例,对照组(择期手术不行结肠灌洗)36例,回顾性分析患者的临床资料。结果观察组术后发生吻合口瘘2例(3.92%),低于对照组7例(19.44%),手术时间(223.98±6.39)min长于对照组(179.22±6.20)min,差异有统计学意义(P<0.05),术后发生切口感染3例(5.88%),高于对照组1例(2.78%),但无统计学意义,均经对症治疗后痊愈。结论在严格掌握手术适应证,充分进行术中结肠灌洗,规范实施手术操作,加强术后管理等前提下,对直肠癌伴梗阻患者给予I期Dixon手术是安全可行的。Objective To explore the treatment effect of rectal cancer with obstruction underwent single-stage Dixon radical operation. Methods A number of 87 cases of rectal cancer with obstruction underwent a single-stage Dixon radical operation were selected as the research object, and they were divided into the study group （emergency operation with colon irrigation） （n = 51） and the control group （selective operation without colon irrigation） （n = 36）, and retrospective analyzed their clinical data. Results The incidence of the anastomotie leakage was lower in the study group than that in the control group, and the operative time was longer than the control group （3.92% vs 19.44%, 223.98 ±6.39 vs 179.22 ±6.20, P 〈 0.05）, which was significant different. There was no significant difference between two groups in the incidence of the incision infection （5.88% vs 2.78%, P 〉0.05）, and all took the symptomatic treatment to heal. Conclusions Under the premise of strictly grasping the surgical indications and full intraoperative colonic irrigation, standardize the operation operation, strengthening postoperative management, rectal cancer with obstruction underwent a single-stage Dixon radical operation is safe and feasible.

关 键 词：直肠癌 梗阻 经腹直肠癌切除术 结肠灌洗 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]