【摘要】 目的探讨左半结肠癌致急性肠梗阻的外科手术方法。方法将2008年1月~2013年1月期间在我院普外科住院治疗的65例左半结肠癌致急性肠梗阻的患者,行Ⅰ期肠切除吻合术47例,经腹结肠癌切除、近端造口、远端封闭术(Hartmann手术)13例,先行结肠造口Ⅱ期手术5例。结果术后并发症发生14例占21.54%(14/65),住院10~18 d,近期治愈65例占100%(65/65)。随访1年65例患者,生存者62例占95.38%(62/65),随访3年者62例,生存者51例占82.25%(51/62),随访5年者51例,生存者21例占41.18%(21/51)。结论科学合理总结分析左半结肠癌致急性肠梗阻患者的疾病情况,应选择合理的术式,尽量让患者行Ⅰ期切除吻合术,可避免Ⅱ期手术给患者带来的痛苦和经济负担,并加强围手术期管理对降低并发症、提高疗效至关重要。更多还原

【Abstract】 Objective To investigate the surgical methods of left colonic carcinoma induced acute intestinal obstruction.Methods Sixty-five patients with left colonic carcinoma induced acute intestinal obstruction hospitalized in the general surgery department of our hospital from January 2008 to January 2013 were selected,of which 47 patients received phase I intestinal resection and anastomosis,13 patients received transabdominal colon resection,proximal stoma and distal closure surgery(Hartmann surgery),and 5 patients received phase Ⅱ colostomy.Results Postoperative complications occurred in 14 patients,accounting for 21.54%(14/65).After 10 to 18 days of hospitalization,65 patients were cured,accounting for 100%(65/65).One-year follow-up included 65 patients,of which 62 patients survived,accounting for 95.38%(62/65).Three-year follow-up included 62 patients,of which 51 patients survived,accounting for 82.25%(51/62).Five-year follow-up included 51 patients,of which 21 patients survived,accounting for 41.18%(21/51).Conclusion Rational surgical methods should be selected after analyzing the patients’ disease conditions scientifically and rationally.Phase Ⅰ resection and anastomosis should be the primary choice in order to avoid the pain and economic burden brought by phase Ⅱ surgery.Enhancing perioperative management is the key to reduce complications and improve efficacy.更多还原