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目的 探讨肿瘤切除一期吻合治疗梗阻性左半结肠癌的可行性和安全性，以期进一步降低手术并发症率和死亡率。方法 回顾性分析我院近１８ａ来用肿瘤切除一期吻合治疗梗阻性左半结肠癌的临床病例。结果 在收治的梗阻性左半结肠癌５６例中，行肿瘤切除一期吻合术３７例（６６％）。其中２５例施行了术中结肠灌洗、肿瘤切除一期吻合术，７例施行了结肠次全切除、回结肠吻合术，另５例作了直接肿瘤切除一期吻合术。有５例发生并发症（１３．５％），包括吻合口漏１例，后经分期手术治愈。一创老年患者术后因严重肺部感染发生呼吸衰竭而死亡，手术病死率为２．７％，平均住院时间１５．６ｄ。结论 只要严格掌握梗阻性左半结肠癌一期切除吻合的适应证与技术要点，手术应属安全可行。
Objective To investigate the feasibility and safety of primary resection of obstructive left colon cancer with tumor resection in order to further reduce the rate of surgical complications and mortality. Methods We retrospectively analyzed the clinical cases of obstructive left colon cancer treated with tumor resection in the past 18 years. Results Of 56 patients with obstructive left colon cancer, 37 patients (66%) underwent one-stage anastomoses for tumor resection. Twenty-five patients underwent intraoperative colonic lavage and one-stage anastomoses for tumor resection. Seven patients underwent subtotal colectomy and ileo-colonic anastomosis. The other 5 patients underwent direct tumor resection and one-stage anastomosis. There were 5 cases of complications (13.5%), including anastomotic leak in 1 case, and were cured by staged surgery. One elderly patient died of respiratory failure due to severe lung infection. The surgical mortality rate was 2.7%, and the average length of stay was 15.6 days. Conclusion As long as the strict indications for the primary resection and anastomosis of obstructive left colon cancer are indicated, the operation should be safe and feasible.