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左结肠梗阻性癌的传统治疗方法是在近端结肠先作减压术,继而再切除癌肿,施行一期吻合术。这种方法需行两次或三次手术,因左结肠癌的一期切除吻合术并发吻合口漏的危险性较高。Fielding 和 Wells 报道,梗阻性癌采用一期切除吻合术的5年生存率较分期手术的高。通常认为,右结肠的梗阻性癌适用一期右半结肠切除,回结肠吻合术。这种方法将结肠的梗阻段连同癌肿一并切除而将末端回肠与不扩张的结肠吻合。Goligher(1980)提议,左结肠梗阻性癌可采用次全或全结肠切除,回肠乙状结肠或回肠直肠吻合术。
The traditional treatment for left colonic obstructive cancer is to perform decompression in the proximal colon, then remove the cancer and perform an anastomosis. This method requires two or three surgeries, because the risk of anastomotic leakage is higher with one-stage resection and anastomosis of left colon cancer. Fielding and Wells reported that the 5-year survival rate of primary resection and anastomosis for obstructive cancer was higher than that of staged surgery. It is generally believed that a right colonic obstruction and a ileocolic anastomosis are suitable for obstructive cancer of the right colon. This method removes the obstructed segment of the colon along with the cancer and matches the terminal ileum with the non-dilated colon. Goligher (1980) proposed that subtotal or total colectomy, ileal sigmoid or ileojejunostomy can be used for left colonic obstructive cancer.