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目的 探讨乙状结肠肿瘤的诊治方法。方法 回顾分析了 198例乙状结肠肿瘤诊疗经过。结果 198例中恶性肿瘤 193例 (97.5 %) ,良性肿瘤 5例 (2 .5 %)。其临床表现依次为便血(6 3.7%) ,排便习惯改变 (32 .7%) ,腹痛 (2 9.3%) ,腹胀 (11.5 %) ,急性肠梗阻 (8.6 %) ,包块 (6 .8%)。181例经纤维结肠镜明确诊断 ,17例经剖腹探查明确诊断。全组均行手术治疗。其中根治性切除140例 (70 .6 %) ,姑息性切除 34例 (17.2 %) ,造瘘 18例 (9%) ,单纯探查 6例 (3.2 %)。发生肠瘘 4例(2 %) ,无手术死亡病例。结论 乙状结肠肿瘤临床表现无特异性 ,对不明原因便血及排便习惯改变应及时行结肠镜检查以明确诊断。根治性切除是乙状结肠肿瘤的最佳治疗方法。伴孤立肝转移灶、可一并切除。乙状结肠肿瘤并急性肠梗阻可行I期结肠切除吻合术。
Objective To investigate the diagnosis and treatment of sigmoid colon tumors. Methods A retrospective analysis of 198 cases of sigmoid colon tumor after treatment. Results Among the 198 cases, 193 were malignant (97.5%) and 5 were benign (2.5%). The clinical manifestations were as follows: blood in the stool (6 3.7%), bowel habits change (32.7%), abdominal pain (2. 9.3%), abdominal distension (11.5%), acute intestinal obstruction (8.6% ). 181 cases were diagnosed by fiber colonoscopy, and 17 cases were confirmed by laparotomy. All patients underwent surgical treatment. There were 140 cases (70.6%) with radical resection, 34 cases (17.2%) with palliative resection, 18 cases (9%) with fistula and 6 cases (3.2%) with simple exploration. Fistula occurred in 4 cases (2%), no surgical deaths. Conclusion The clinical manifestations of sigmoid colon tumor is nonspecific. Colonoscopy should be performed in time to clarify the diagnosis of abnormal blood in the stool and bowel habits. Radical resection is the best treatment for sigmoid tumors. With isolated liver metastases, can be removed together. Sigmoid colon tumor and acute intestinal obstruction feasible I colorectal anastomosis.