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我院1976~1997年共收治梗阻性大肠癌52例,其中男30例,女22例,年龄最大82岁,最小26岁,平均为55.66岁,这些病人术前分别被诊断为肠梗阻、不完全性肠梗阻、低位肠梗阻和粘连性肠梗阻,还有5例术前诊断为肠套叠,1例诊断为腹痛待查。1例结肠脾曲癌致小肠穿孔,行穿孔修补回肠乙状结肠侧侧吻合,术后发生中毒性休克,自动出院;1例老年升结肠癌病人因肿瘤无法切除,行回肠横结肠侧侧吻合术后第2天死于休克;1例结肠脾曲癌病人行部分结肠、脾胰切除术、术后发生吻合口瘘,自动出院,1例乙状结肠癌穿孔,行肿瘤切除,结肠造瘘;1例老年病人横结肠癌行回肠造瘘;1例横结肠癌病人因病灶无法切除行回肠、降结肠侧侧吻合;1例结肠肝曲癌行根治术加部分肝叶切除术;1例结肠脾曲癌行部分结肠切除术后伤口感染,经换药治愈。余均行根治术加I期吻合术,无吻合口瘘发生。癌灶所分布的部位分别为升结肠和回盲部15例、结肠肝曲12例,横结肠3例,结肠脾曲12例,降结肠3例,乙状结肠7例。
In our hospital from 1976 to 1997, a total of 52 cases of obstructive colorectal cancer were treated, including 30 males and 22 females. The oldest was 82 years old, and the youngest was 26 years old. The average was 55.66 years. These patients were diagnosed as intestinal obstruction before operation. Complete intestinal obstruction, low intestinal obstruction and adhesive intestinal obstruction, there are 5 cases of preoperative diagnosis of intussusception, 1 case of abdominal pain to be investigated. One case of colonic splenic carcinoma caused by perforation of the small intestine, perforation repair sigmoid sigmoid collateral anastomosis, postoperative toxic shock, automatic discharge; 1 case of elderly patients with ascending colon cancer due to tumor can not be removed after ileotranscolonic collateral anastomosis Two days died of shock; 1 patient with colonic splenic curvature had partial colon and splenectomy, postoperative anastomotic leakage, automatic discharge, 1 case of sigmoid colon cancer perforation, tumor resection, and colostomy; 1 elderly patient Transverse ileocarcinoma was performed in horizontal colon cancer. One patient with transverse colon cancer could not be resected for ileum and descending colon side-to-side anastomosis; one case of colonic hepatic cancer underwent radical surgery plus partial hepatectomy; one case of colon splenic carcinoma was performed with partial colon Wound infection after resection, cured by dressing change. Yu Jun line radical surgery plus I stage anastomosis, no anastomotic fistula occurred. The tumor sites were distributed in 15 cases of ascending colon and ileocecal, 12 cases of colonic hepatic curvature, 3 cases of transverse colon, 12 cases of colon splenic flexure, 3 cases of descending colon, and 7 cases of sigmoid colon.