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目的评价次全结肠切除在治疗癌性左半结肠梗阻中的价值。方法总结左半结肠癌导致的28例急性肠梗阻患者采用次全结肠切除术的临床资料。结果男19例,女9例;年龄27～86(平均65.7)岁。均因急性肠梗阻收住院,从发病到手术间隔时间41～143(平均87)h。入院后均快速给予术前准备,在全麻下行次全结肠切除术,回肠结肠或直肠吻合术,其中根治性切除21例,姑息性切除7例,均痊愈出院,未出现吻合口瘘或死亡。术后每天排便1～2次。姑息切除的7例患者均在术后16个月内死亡,根治性切除的21例患者的1、3、5年生存率分别为100%、77.8%(14/18)和57.1%(8/14)。结论次全结肠切除是治疗梗阻性左半结肠癌的有效和安全术式。
Objective To evaluate the value of subtotal colectomy in the treatment of cancerous left-sided obstruction. Methods The clinical data of subtotal colectomy in 28 patients with acute intestinal obstruction caused by left colon cancer were summarized. Results There were 19 males and 9 females, ranging in age from 27 to 86 (mean, 65.7) years. All admitted to hospital due to acute intestinal obstruction, from the onset of surgery interval 41 ~ 143 (average 87) h. All patients were given preoperatively promptly under general anesthesia for subtotal colon resection and ileum colon or rectal anastomosis. Radical resection was performed in 21 cases and palliative resection in 7 cases. All patients were cured and discharged without anastomotic fistula or death . Defecation 1 to 2 times a day after surgery. The seven patients who died of palliative resection all died within 16 months after operation. The 1, 3, 5-year survival rates of the 21 patients who underwent radical resection were 100%, 77.8% (14/18) and 57.1% (8 / 14). Conclusions Subtotal colon resection is an effective and safe procedure for the treatment of obstructive left colon cancer.