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目的观察左侧结肠癌伴急性肠梗阻一期手术的疗效,探讨理想的手术治疗方法。方法回顾性分析四川大学华西医院2007年1月至2009年11月期间收治的46例左侧结肠癌伴急性肠梗阻患者一期手术切除吻合的临床资料。结果 46例均未实施术中结肠灌洗,而行彻底的无污染肠减压法。其中行根治性切除一期吻合35例,姑息性切除一期吻合11例。术后发生吻合口漏3例,切口感染6例,肺部感染2例,盆腔积液1例,均经非手术方法治愈。全组手术无死亡病例。结论左侧结肠癌伴急性肠梗阻一期切除吻合,用彻底的无污染肠减压法替代结肠灌洗是安全、可行的。
Objective To observe the curative effect of primary surgery for left colon cancer with acute intestinal obstruction and to explore the ideal surgical treatment. Methods The clinical data of 46 cases with left colon cancer with acute intestinal obstruction who underwent primary surgical resection and anastomosis at West China Hospital of Sichuan University from January 2007 to November 2009 were retrospectively analyzed. Results None of the 46 patients underwent intraoperative colonic lavage, while a complete non-staining intestinal decompression method. One line of radical resection of 35 cases of anastomosis, palliative resection of anastomosis in 11 cases. Postoperative anastomotic leakage in 3 cases, incision infection in 6 cases, 2 cases of lung infection, pelvic effusion in 1 case, were cured by non-surgical methods. The whole group of surgery without deaths. Conclusion The left colon cancer with acute intestinal obstruction in the first stage of resection and anastomosis, with a complete non-polluting intestinal decompression instead of colon lavage is safe and feasible.