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目的总结升结肠回盲部肿瘤侵犯乙状结肠的治疗经验。方法升结肠回盲部肿瘤侵犯乙状结肠22例,术前诊断明确7例,其余均为术中明确诊断,急诊手术11例(占50.0%),均行多发结肠肿瘤肠段切除术,其中一期吻合5例,预防性小肠造口11例,降结肠造口6例,包括右侧输尿管部分切除5例,肉眼达到R0根治性切除21例,1例因右侧髂内血管侵犯行姑息性肿瘤切除。结果术后患者恢复好,无死亡患者,无肠漏及吻合口漏。预防性小肠造口患者于术后1个月余行造口还纳手术,3例降结肠造口患者于术后半年行造口还纳术,另有3例随访无异常。结论升结肠回盲部肿瘤侵犯乙状结肠患者行根治性肿瘤切除,可提高患者生存率及生活质量,采用多肠段切除一期吻合或预防性小肠造口是一种合理的手术方式,如必须行结肠造口术时,需为二次手术创造条件。
Objective To summarize the treatment experience of invading the sigmoid colon with ascending ileocecal tumor. Methods Ascending ileocecal tumor invasion of the sigmoid colon in 22 cases, 7 cases were diagnosed before surgery, and the rest were clear diagnosis of surgery, emergency surgery in 11 cases (50.0%), multiple bowel resection colon cancer surgery, including a 5 cases were anastomosed, prophylactic small intestine stoma in 11 cases, descending colostomy in 6 cases, including the right ureter partial resection in 5 cases, macroscopic R0 radical resection in 21 cases, 1 case of right internal iliac vascular invasion of palliative tumors resection. Results Postoperative patients recovered well, no deaths, no intestinal leakage and anastomotic leakage. Patients with prophylactic small intestinal stoma were surgically surgically treated at one month after surgery. Three patients with descending colonic stoma received a stapes operation for six months after operation, and no abnormalities were observed in the other three cases. Conclusion Ascending colon ileocecal tumor invasion of sigmoid colon patients with radical tumor resection, can improve patient survival and quality of life, the use of multiple bowel resection of anastomotic or prophylactic intestinal ostomy is a reasonable method of operation, such as the need to line Colostomy, the need for the second surgery to create conditions.