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目的:探讨左半结肠癌急性梗阻一期手术的可行性及适应证。方法:回顾性分析46例左半结肠癌急性梗阻的手术方式及术中处理情况。结果:本组46例均行手术治疗,其中一期切除及吻合35例(其中包括肿瘤姑息切除吻合5例),Hartmann手术8例(一期切除二期吻合),肿瘤无法切除行捷径手术或双腔造瘘3例。发生吻合口瘘2例,因合并急性心肌梗死死亡1例。结论:左半结肠癌急性梗阻一期切除吻合是可行的;术中彻底灌洗、消毒及选择性一期吻合是安全的保证。
Objective: To explore the feasibility and indications of the first-stage operation for acute obstruction of left colon cancer. Methods: A retrospective analysis of 46 cases of acute obstruction of left colon cancer surgery and intraoperative treatment. RESULTS: All the 46 cases underwent surgical treatment, including one stage resection and anastomosis in 35 cases (including palliative resection of the tumor in 5 cases), Hartmann operation in 8 cases (one stage resection of two-stage anastomosis), and the tumor could not be removed for short-cut surgery or Double cavity fistula in 3 cases. Anastomotic fistula occurred in 2 cases, 1 case died of acute myocardial infarction. Conclusion: One-stage resection and anastomosis for acute obstruction of left colon cancer is feasible; thorough lavage, disinfection and selective first-phase anastomosis are the guarantee of safety.