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目的探讨结直肠癌急性肠梗的个体化手术治疗效果。方法 2006年2月至2009年5月,本院外科收治22例因结肠引起的肠梗阻,全组病例均行手术治疗,4例行Ⅰ期根治性肠切除+吻合术;14例行根治性切除+近断结肠造瘘术;2例行经腹会阴切除术;2例因肿瘤无法切除,行横结肠双腔造瘘术。结果 14例行肠切除Ⅰ期肠吻合者均未发生吻合口瘘,全部病例均安全度过手术关。术后病理诊断22例均确诊为结肠腺癌。结论对右半结肠癌性梗阻均可行Ⅰ期根治性右半结肠切除吻合术;左半结肠癌性梗阻须根据不同情况,采取个体化手术方案,才能取得满意的效果。
Objective To investigate the individualized surgical treatment of colorectal cancer with acute intestinal obstruction. Methods From February 2006 to May 2009, 22 cases of intestinal obstruction caused by colonic were treated surgically in our hospital. Surgical treatment was performed in all cases and radical resection + anastomosis in stage Ⅰ in 4 cases. Radical resection was performed in 14 cases Excision + proximal colostomy; 2 cases underwent perineal resection; 2 cases of tumor can not be removed, transverse colon double-chamber ostomy. Results Anastomotic fistula was not found in all 14 patients underwent intestinal resection of stage Ⅰ intestine anastomosis, and all the cases were safely surgically closed. Postoperative pathological diagnosis of 22 cases were diagnosed as colon adenocarcinoma. Conclusions The first right colon resection and anastomosis is feasible for right-sided colon cancer with obstruction. The left-sided colon cancer obstruction should be treated according to different conditions and individualized surgery plan can achieve satisfactory results.