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目的探讨左半结肠癌合并肠梗阻手术治疗临床效果。方法回顾性分析2006~2010年收治的48例左半结肠癌合并肠梗阻患者不同术式手术治疗的临床资料。结果术后证实肿瘤部位分布:结肠脾区4例,降结肠8例,乙状结肠20例,乙状结肠直肠交界处15例,重复癌1例。31例(64.6%)患者治愈,14例(29.2%)患者复发二次手术。围手术期发生呼吸衰竭死亡1例,术后切口感染4例,其中裂开1例,并发坠积性肺炎2例,吻合口瘘1例。结论准确掌握适应证,可采用不同术式,应重视全结肠灌洗,尽量采用Ⅰ期手术治疗,可获得较好的临床疗效。
Objective To investigate the clinical effect of surgical treatment of left colon cancer with intestinal obstruction. Methods The clinical data of 48 cases of patients with left colon cancer complicated with ileus treated by different surgical procedures from 2006 to 2010 were analyzed retrospectively. Results Postoperatively, the distribution of the tumor was confirmed: 4 cases of colon and spleen, 8 cases of descending colon, 20 cases of sigmoid colon, 15 cases of sigmoid colon and rectum and 1 case of recurrent carcinoma. Thirty-one patients (64.6%) were cured and 14 (29.2%) patients underwent secondary surgery. Perioperative respiratory failure occurred in 1 case, 4 cases of incision infection, including 1 case of split, complicated by hypostatic pneumonia in 2 cases, 1 case of anastomotic fistula. Conclusion Accurate indications of indications, can be used in different surgical procedures, should pay attention to the whole colon lavage, try to use Ⅰ surgical treatment, get better clinical efficacy.