摘要
目的探讨急性肿瘤性结直肠梗阻的外科急诊治疗策略。方法回顾性分析98例急性肿瘤性结直肠梗阻患者的临床病例资料。结果全部患者经手术治疗,包括急诊手术78例,其中右半结肠癌25例均行一期切除吻合手术,左半结肠癌45例中一期切除吻合39例,直肠癌8例,均行急诊手术;择期性手术20例,行姑息性结肠造口2例,另4例经肛门插入导管减压去污后行一期手术。手术切口感染3例,肺部感染2例,无吻合口漏发生,无手术死亡病例。结论对于急性肿瘤性结直肠梗阻的外科急诊治疗中除非有急诊手术指征,否则应首先采用非手术治疗1～3d,再尽可能转为择期手术;对于选择性手术病人,一期肠切除吻合术是安全可行的;经肛门插入导管减压、灌冼去污是对一期肠切除吻合术的有效补充。
Objective To investigate the strategy for emergent surgical management of acute neoplastic colorectal obstruction, Methods The Clinical data of 98 patients diagnosed as acute neoplastic coloreetal obstruction were retrospectively analyzed, Results In this group, 78 cases underwent emergent surgical treatment. Among them, 25 cases with carcinoma in right colon underwent primary resection and anastomosis, 39 of 45 cases with earcinoma in left colon were performed by primary resection and anastomosis and emergent operations were performed in 8 cases of rectal cancer. Palliative colostomy was perfomed in 2 cases, Decompression and decontamination by transanal ileus tube and then primary, anastomosis was performed in other 4 cases, The remaining 20 cases received non - emergent operation. Wound infection occurred in 3 cases as surgical complication and no anastomotic leakage appeared , Pulmonary infection was occurred in 2 patients, There was no surgical death in all cases, Conclusion For emergent management of acute neoplastic eolorectal obstruction, non - surgical treatment should be kept for 1 - 3d in order to make non - emergent surgical treatment be more possible. One - stage resection and primary anastomosis are feasible and safe in selected cases. Decompression and decontamination by transanal ileus tube is an effective complementary measure for one -stage resection and primary anastomosis,
出处
《临床和实验医学杂志》
2008年第6期37-39,共3页
Journal of Clinical and Experimental Medicine
关键词
结直肠肿瘤
急性肠梗阻
外科治疗
Colorectal cancer
Acute intestinal obstructions
Surgical treatment
