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目的 探讨大肠癌致肠梗阻的诊断和手术方法。方法 回顾分析 1990～ 2 0 0 0年间 4 9例大肠癌致肠梗阻病例的外科治疗资料。结果 4 6例结肠癌致肠梗阻病人一期右半结肠切除吻合 10例 ,一期左半结肠切除吻合 2 7例 ,一期左半结肠切除吻合 ,近端结肠造口 6例 ,左半结肠切除、近端结肠造口、关闭远端结肠 3例 ( Hartmann造口 )。3例直肠癌致肠梗阻病人 ,肿瘤无法切除 ,作乙状结肠造口 1例 ,横结肠造口 ,肠梗阻缓解后行 Mile’s手术 2例。全组无吻合口瘘和死亡病例。结论 为了提高 5年生存率和减少二期手术 ,结肠癌致肠梗阻应争取一期切除吻合。合理选择手术方法 ,做好术中结肠灌洗和围手术期治疗是手术成功的关键。文章还强调了大肠癌早期诊断的重要性。
Objective To investigate the diagnosis and surgical methods of intestinal obstruction caused by colorectal cancer. Methods Retrospective analysis of surgical treatment data of 49 cases of bowel obstruction caused by colorectal cancer between 1990 and 2000. Results A total of 46 patients with colonic obstruction caused by colon cancer were treated with resection and anastomosis of the right hemi-colony in 10 cases, one stage of resection and anastomosis of the left hemi-colectomy in 27 cases, one stage of resection and anastomosis of the left hemi-colonic colitis, and 6 cases of colostomy of the proximal colon. Resection, proximal colostomy, and distal closure of the colon in 3 cases (Hartmann Ostomy). In 3 patients with intestinal obstruction caused by rectal cancer, the tumor could not be removed. There was 1 sigmoid colostomy, transverse colon colostomy, and Mile’s operation was performed in 2 patients after intestinal obstruction was relieved. There were no anastomotic fistulas and deaths in the entire group. Conclusions In order to improve the 5-year survival rate and reduce the secondary surgery, intestinal obstruction caused by colon cancer should strive for a one-stage resection and anastomosis. Reasonable choice of surgical methods, good intraoperative colonic lavage and perioperative treatment are the keys to successful operation. The article also emphasized the importance of early diagnosis of colorectal cancer.