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目的 探讨结肠癌并发急性肠梗阻的外科治疗原则和Ⅰ期切除吻合的可能性。方法分析 1994～ 1998年收治的 17例结肠癌并发急性肠梗阻的外科治疗情况 ,并收集同期国内正式发表的40篇有关此病的外科治疗报道 ,共计 1889例 ,结合文献综合评价其外科治疗方法。结果 全组切口感染 12 4例 ,占 6 .6 % ;肺部感染 2 1例 ,占 1.1%。 1889例中 ,有 15 98例做切除吻合 ,发生吻合口瘘 5 0例 ,占 3 1%。手术死亡 93例 ,占 4.9%。术后 5年生存率 :Ⅰ期切除吻合者为 2 6 .0 %～ 48.0 % ,分期手术者为 2 0 .0 %～ 38.0 %。结论 结肠癌并发急性肠梗阻的处理需根据患者具体情况决定手术方式 ,Ⅰ期切除吻合有可能获得良好的效果 ,但必须注意手术技术、术中肠道灌洗、合理应用抗菌素和严格掌握适应证。
Objective To investigate the principle of surgical treatment of acute intestinal obstruction complicated by colon cancer and the possibility of resection and anastomosis of stage I. METHODS: Surgical treatment of acute intestinal obstruction was performed in 17 cases of colon cancer admitted from 1994 to 1998. 40 surgical reports on the disease were published in the same period. A total of 1889 cases were collected. . Results In the whole group, there were 12 cases of wound infections, accounting for 6.6 %; 21 cases of lung infections, accounting for 1.1%. In 1889 cases, 15 98 cases were performed resection and anastomosis, and 50 cases of anastomotic fistula occurred, accounting for 31%. Surgical deaths were 93 cases, accounting for 4.9%. The 5-year survival rate after surgery was 26.0 to 48.0 % in patients who underwent resection and anastomosis in stage I, and 20.0 to 38.0 % in staged surgery. Conclusion The treatment of acute intestinal obstruction complicated by colonic cancer should be based on the specific circumstances of the patient. Surgical technique may be used for resection and anastomosis in stage I. However, surgical techniques, intraoperative intestinal lavage, rational use of antibiotics and strict indications must be observed. .