论文部分内容阅读
目的探讨结肠癌致急性肠梗阻的外科治疗,结肠癌一期切除吻合外科处理方法及手术前后处理,术中结肠造口灌洗减压。方法回顾分析2002年1月～2007年10月结肠癌切除吻合59例。结果对一般情况较好的患者,掌握好手术的适应证,行一期切除吻合,可减少患者痛苦及二次手术,防止癌肿扩散,提高远期治疗效果及生存率、治愈率。结肠并发梗阻时,一是解除梗阻,二是切除肿瘤。对盲肠、升结肠肿瘤或结肠肝曲肿瘤,行右半结肠切除一期吻合术;对左半结肠癌致急性肠梗阻,采取一期切除吻合近端肠管袢式造瘘取得了较好疗效。对年龄大,一般情况差,梗阻时间长,肠管直径超过8cm,肠壁色泽差、水肿明显,肠腔内大量粪便堆积,贫血、脱水、电解质失调纠正不理想者,则以单纯肠造口术或捷径者分期手术为宜。结论重视对结肠癌一期切除的认识,严格掌握手术的适应证,合理选择手术方式,提高远期治疗效果及生存率、治愈率。
Objective To investigate the surgical treatment of acute intestinal obstruction caused by colon cancer, surgical treatment of primary resection and anastomosis of colon cancer, and preoperative and postoperative management of colorectal cancer. Intraoperative colostomy lavage decompression. Methods Retrospective analysis of January 2002 ~ October 2007 colon resection and anastomosis in 59 cases. Results In patients with good general conditions, to master the indications for surgery, a line of resection and anastomosis can reduce the pain and secondary surgery patients to prevent the spread of cancer and improve the long-term treatment and survival rates, the cure rate. Colon obstruction, one to lift the obstruction, the second is to remove the tumor. On the cecum, ascending colon tumors or colorectal liver tumors, the right half of the colon resection of an anastomosis; caused by acute colon obstruction of the left colon cancer, to take a resection anastomosis proximal intestinal ostomy made a good effect. For large age, poor general condition, obstruction for a long time, bowel diameter more than 8cm, intestinal wall color difference, obvious edema, a large accumulation of stool in the intestine, anemia, dehydration, electrolyte imbalance correction is not ideal, then pure enterostomy Or shortcut staging surgery is appropriate. Conclusions The importance of primary resection of colon cancer awareness, strict surgical indications, a reasonable choice of surgical approach to improve the long-term treatment and survival rates, cure rates.