急性梗阻性大肠癌的外科治疗探讨

目的探讨急性肠梗阻性大肠癌的外科治疗方法。方法回顾性分析我院收治的1994年至2008年85例急性梗阻性大肠癌的外科治疗资料。在36例右半结肠癌中,35例行一期右半结肠切除术,1例行捷径手术,在49例左半结肠及直肠癌中,36例行一期切除术,5例单纯造瘘术,5例行麦氏术,3例行Har-tm ann术。结果一期右半结肠切除35例顺利康复,1例重度感染休克死亡;一期左半结肠切除34例,1例肠麻痹,MoF死亡,6例切口感染,2例吻合口漏,再次行横结肠造瘘术。结论对于急性梗阻性大肠癌,应遵循个体化原则,合理选择手术方法,右半结肠癌性肠梗阻,可行一期手术,对于左半结肠癌性急性肠梗阻,行一期手术是可行的,手术并发症的发生率与分期手术的发生率相仿。

Surgical treatment for large intestine cancer with acute obstruction

Objective To study the surgical treatment for large intestine cancer with acute obstruction.Method 85 clinical documents of large intestine cancer with acute obstruction treated in our hospital from 1994 to 2008 were retrospectively analysed.In 36 cases of risut hemicolon cancer,35 cases underwent resection（Primary suture）,1 case underwent by pass procedures.In the other 49 cases of left hemicolon cancer and rectume cancer,36 cases underwent rection（primary suture）,5 cases simple colstomy,5 cases Miles and 3 cases Hart-mann. Result 35 cases with risht hemicolectomy recovered. 1 case died from severe infection and shock. Of the 34 cases of left hemi eolectomy, 1 case died from MOF. 6 eases suffered from cut infecticon, 2 eases of anastomotie leakage received transverse eolostomy. Conclusion Reasonable surgical trentment should be selected according to different cases of large intestine cancer with Mute obstruction. Risht hemicolon cancer can be treated with resection （primauy suture） while for left hemicolon cancer, resection（primary sutare） is feasible, with the postoperative complication similar to that of the multi-step operation.