左半结直肠癌并急性肠梗阻经内镜介入治疗后再限期手术 的临床应用探讨

目的:探讨左半结直肠癌并急性肠梗阻经内镜介入治疗后再限期行肿瘤根治切除及一期肠吻合术的临床应用价值.方法:回顾性分析2006年-2011年我院收治的87例左半结直肠癌并急性肠梗阻的临床资料.结果:本组87例中,71例经内镜置入支架或肠梗阻导管介入减压治疗成功并完成了肿瘤根治性切除及一期肠吻合术.16例介入治疗失败行了急诊手术治疗,其中支架或导管置入失败7例,堵塞5例,减压效果差4例,无穿孔、出血并发症,介入治疗有效率81.6％.限期手术后切口感染5例(7.0％)；急诊手术后切口感染4例(25.0％)；吻合口漏2例(2.8％)；无死亡病例发生.结论:左半结直肠癌并急性肠梗阻经内镜介入治疗后,限期行肿瘤根治性切除及一期肠吻合术,可以最大限度降低术后切口感染、吻合口漏机率,值得临床推广应用.

The Clinical Application of Deadline for Surgery after the Left Half of Colorectal Cancer and Acute Intestinal Obstruction by Endoscopic Treatment

Objective: To investigate the clinical value of deadline for radical tumor resection and an intestinal anastomosis after the left half of colorectal cancer and acute intestinal obstruction by endoscopic treatment.Methods: Retrospective analysis of 2006 to 2011 in our hospital’s clinical data of 87 cases of the left half of colorectal cancer and acute intestinal obstruction.Results: In this 87 cases,71 cases of endoscopic stenting or intestinal obstruction catheterization decompression treatment success and complete tumor radical resection and an intestinal anastomosis.16 cases involved in treatment failure line emergency surgery,Stent or catheter implant failure in 7 cases,plug in 5 cases,the decompression effects of poor 4 cases,no perforation and bleeding complications,interventional treatment efficiency 81.6%.Wound infection in 5 cases(7.0%) after Deadline surgery;wound infection in 4 cases(25.0%) after emergency post-operative;Anastomotic leakage in 2 cases(2.8%);no deaths have occurred.Conclusions: The deadline for radical tumor resection and an intestinal anastomosis after the left half of colorectal cancer and acute intestinal obstruction by endoscopic treatment,can minimize postoperative infection,anastomotic leakage probability,is worthy of clinical application.