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目的 :探讨左半结肠癌并发急性肠梗阻的外科处理方法。方法 :回顾分析 1990年 8月～ 2 0 0 3年 12月 4 3例左半结肠癌并发急性肠梗阻的临床资料 ,并进行统计分析。结果 :2例行近端结肠造口 ,Ⅱ期切除治愈 ;5例行Hartmann术治愈 ;36例行Ⅰ期切除吻合术 ,其中 13例行吻合口肠段外置术 ,发生吻合口瘘 1例 (2 .8% ) ,1例因合并病术后放弃治疗 ,出院时打开吻合口前壁作永久造口用 ;全组无手术死亡 ,并发症少。结论 :Ⅰ期切除吻合治疗左半结肠癌并肠梗阻是可行的 ,而合理地选择手术方式 ,正确的术中操作和围手术处理对提高疗效 ,改善患者的生活质量有所裨益。
Objective: To investigate the surgical treatment of left colon cancer with acute intestinal obstruction. Methods: The clinical data of 43 patients with left colon cancer complicated with acute intestinal obstruction from August 1990 to December 2003 were retrospectively analyzed and statistically analyzed. Results: 2 cases of proximal colostomy, Ⅱ resection and cure; 5 cases were cured Hartmann; 36 cases of stage Ⅰ resection and anastomosis, of which 13 cases of anastomotic intestinal segment surgery, anastomotic fistula occurred in 1 case (2 .8%). One patient was given up for treatment after the merger, and the anastomotic anterior wall was opened for permanent ostomy with discharge. There was no operative death and fewer complications in the whole group. Conclusion: Stage Ⅰ resection and anastomosis for the treatment of left colon cancer and intestinal obstruction is feasible, and a reasonable choice of surgical approach, the correct operation and perioperative surgical treatment to improve the efficacy and improve the quality of life of patients benefit.