摘要
目的 探讨左侧梗阻性大肠癌Ⅰ期切除吻合的技术 ,适应征及术后效果。方法 对左侧梗阻性大肠癌 ,实施Ⅰ期切除吻合术 75例 ;实施Ⅱ期或Ⅲ期手术治疗 79例作对照。结果 Ⅰ期切除吻合组切口感染 8例 ( 10 8% ) ,切口裂开 5例 ( 6 8% ) ,因粘连性肠梗阻再手术 2例 ( 2 7% ) ,吻合口瘘 3例 ( 4 % ) ,并发症为 2 1 6% ;Ⅱ或Ⅲ期手术组切口感染2 3例 ( 2 9 1% ) ,切口裂开 16例 ( 2 0 3 % ) ,并发症为 49 4(P <0 0 5 )。 3、5年生存率 ,Ⅰ期切除吻合组为 84%和 40 1% ;Ⅱ或Ⅲ期手术组为 3 0 2 %和 9 2 % (P <0 0 5 )。结论 左侧梗阻性大肠癌 ,Ⅱ、Ⅲ期手术不但使病人受多次手术之苦 ,延长了治疗时间 ,还会增加并发症和降低生存率 。
Objective To consider the operative technique,indication and postoperative effect of the obstructive carcinoma of large intestine.Methods Among 143 patients with left obstructive carcinoma of large intestine,the resection and anastomosis(Defined as stage Ⅰ operative group)was performed on 74 cases,accounting for 51.8%;65 case firstly underwent resection for diseased intestinal canal and colostomy,and then intestinal anastomosis was carried out secondarily(as stage Ⅱ group),accounting for 45.5%;14 cases underwent transverse colostomy,then resection for the canal,and again intestinal anastomosis(as stage Ⅲ group),accounting for 9.8%.Results None of all cases developed operative death.Stage Ⅰ group:8 cases(10.8%) had infection of incisional wound;5 cases(6.8%)had disruption of wound;2 cases(2.7%)underwent reoperation for adhesive ileus;3 cases(4%),had anastomotic leakage.Stage Ⅱ group:15 cases(23.1%)had infection of incisional wound;8 cases(12.1%) had disruption of wound.Stage Ⅲ group:8 cases(57.8%) had infection of incisional wound.The 3-year survival rates were 84%,31.5%,25.8% respectively.The 5-year survival rates were 40.1%,10.5%,8% respectively.Conclusion The stage Ⅰ,Ⅱ operations not only made the patients suffer from reoperation and a longer period of treatment but also increased the complications and reduced the survival rate.It suggests that the stage Ⅰ operation should be adopted.
出处
《四川医学》
CAS
2004年第4期383-384,共2页
Sichuan Medical Journal
关键词
左侧大肠癌
肠梗阻
切除术
left obstructive carcinoma of large intestine
ileus
excision
