经肛肠梗阻导管联合腹腔镜手术治疗结直肠恶性梗阻.pdfVIP

·522· 生堡处整盘查!!!!至!旦筮塑鲞筮!塑g!垫』!!垡：』!堕!Q!!：!塑：塑：№：鱼 ．论著． 经肛肠梗阻导管联合腹腔镜手术治疗 结直肠恶性梗阻 谭志军谷川 张国梁丁文涛靳燕宇 姜伟 【摘要】 目的评价经肛肠梗阻减压导管联合腹腔镜手术在结直肠恶性梗阻治疗中的应用价 值。方法2007年3月至2010年lO月37例急性完全性结直肠恶性梗阻患者经肛置入肠梗阻导管 至梗阻近端肠管，冲洗引流4～10d后行腹腔镜探查并一期切除吻合。结果37例患者中34例成功 置入导管，导管引流时间为4～10d，平均(5．84-1．6)d。置入肠梗阻导管后(3．8±1．3)d (1—7d)患者腹痛、腹胀症状消失。与人院时腹围(924-7)cm相比，手术时腹围(844-6)cm，明显缩 小(P=0．013)。其中3l例患者减压后完成腹腔镜一期根治切除吻合，术后患者恢复顺利，无严重并 发症。结论经肛型肠梗阻减压导管联合腹腔镜手术治疗急性结直肠梗阻安全、有效，可将急诊手术 转为限期手术，在适当的肠道准备后腹腔镜下根治手术并一期吻合是可行的。 【关键词】结直肠肿瘤；肠梗阻；引流；腹腔镜手术 ilens for oftransanalnIbefollowed colorectal Application bylaparoscopicsurgerymalignant obstructionTANZhi Wen—tao。JiN Wei． j．n，GUChuan，ZHANGGuo—liang。DING Yah—yu，JIANG General FirstCentre 300192，China Departmentof Surgery，TianjinHospital，Tiaajin Correspondingauthor：TANZhi-jan，Email：zhijuntan@yahoo．con．ca Toevaluatethe and oftransanal tubefollowed 【Abstract】0bjecfivesafetyefficacy drainage by colorectal FromMarch2007to in of obstruction．Methods laparoscopicsurgerymanagementmalignant October withcolorectalcancer acute mechanicalobstructionwere 2010，37patients manifestingcomplete treatedileustube and from4to10 radical by irrigationdrainageranging days，the operations drainage．After andanastomosiswere The tubeswere in performedbylaparoscopy．Resultsdrainage successfullyimplanted 34 of from4to10d．Theabdominal time patients．Thedecompressionpatientswas(5．84-1．6)d，ranging and werefaded to7