大肠癌并急性肠梗阻外科治疗125例临床研究.doc

大肠癌并急性肠梗阻外科治疗125例临床研究[摘要] 目的 探讨大肠癌并发急性肠梗阻的外科治疗方法及疗效。方法 回顾分析1996年6月～2008年6月125 例肠癌所致急性肠梗阻的临床资料。其中58例不全性肠梗阻先保守治疗,再择期行一期肠切除吻合57例,Miles手术1例;67例完全性肠梗阻急诊手术,行一期肠切除吻合50例,其他术式17例。结果 术后并发症25例(20.00%)。101例获随访(80.80%),2 年生存率82.17 %(83/ 101),5年生存率55.45%(56/ 101)。在一期切除吻合的病例中,急诊手术与择期手术组间术后近期各并发症率比较及2年、5年生存率比较,P值均大于0.05,差异无统计学意义。结论 大肠癌致急性肠梗阻的外科治疗应及时灵活应用不同的手术方式,创造条件力争一期切除肿瘤,解除梗阻。对左半结肠癌并发急性肠梗阻病人急诊施行一期肿瘤切除吻合术是安全有效的。 [关键词] 结直肠肿瘤;肠梗阻;外科治疗 [中图分类号] R735.4[中图分类号] A[文章编号] 1673-9701(2009)24-39-02 Surgery for Colorectal Cancer with Acute Obstruction:A Clinical Analysis of 125 cases LI Li General Surgery,NanchongMunicipal Fifth People? Hospital, Nanchong,Sichuan 637100,China [Abstract] Objective To investigate the efficacy of surgery for colorectal cancer with acute intestinal obstruction. Methods A retrospective analysis of 125 cases of acute intestinal obstruction caused by colorectal cancer(from Jun.1996 to Jun. 2008) was made, in which 58 cases of incomplete intestinal obstruction accepted conservative treatment(57 cases accepted intestinal resection and 1 case accepted Miles operation) and 67 cases of complete obstruction accepted emergency surgery(50 cases accepted intestinal resection and 17 cases accepted other surgical methods). Results Postoperative complications occurred in 25 cases(20.00%). A follow - up of 101 cases(80.80%) showed the 2-years survival rate was 82.17% (83/101) and the 5-years survival rate was 55.45% (56/101).Emergency operation and selective operation were compared with the survival 2- year and 5-year rates,with no statistical significance.(P0.05) Conclusion Colorectal cancer with acute intestinal obstruction should be timely treated and different operations should be flexibly used. We should create conditions to remove the tumor at first time. Tumor resection may be used in left colon cancer with acute intestinal obstruction,which is safe and effective. [Key Words] Colorectal neoplasms;Intestinal obstruction;Surgery 大肠癌合并急性低位肠梗阻是外科常见急腹症之一,