急性梗阻性左侧结直肠癌的手术方式选择与预 防性肠造口.pdfVIP

Asian Case Reports in Oncology 亚洲肿瘤科病例研究, 2017, 6(2), 9-14 Published Online April 2017 in Hans. /journal/acrpo /10.12677/acrpo.2017.62002 Surgical Treatment and Prophylactic Bowel Stoma for Acute Obstruction of Left Colorectal Carcinoma Chen Wang, Hanzhang Huang, Feng Zhou, Pengfei Wang, Shaoliang Han* Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou Zhejiang th st th Received: Jul. 5 , 2017; accepted: Jul. 21 , 2017; published: Jul. 24 , 2017 Abstract Objective: To investigate the selection of surgical treatment for left colorectal carcinoma with acute obstruction and feasibility of prophylactic bowel stoma. Methods: The data of 278 left colon carcinoma patients with acute obstruction (LCCPAO) treated surgically during 15 years were ana- lyzed retrospectively. Results: In this study, there were 59 cases of LCCPAO underwent resection without intestinal anastomosis, and 219 cases of one-stage underwent one-stage resection with intestinal anastomosis. Among the latter cases, 66 underwent one-stage underwent one-stage re- section with enteral anastomosis plus prophylactic colostomy. The procedures were left colecto- my in 24 cases, sigmoid colectomy in 20 cases, subtotal colectomy in 1 case, Dixon’s operation in 13 cases, and intersphincteric resection (ISR) in 8 cases. In addition, 5 cases were treated with expandable metal stent for relieving intestinal obstruction before operation and followed by one-stage resection and anastomosis. The anastomotic leakage rate in patients with one-stage re- section and intestinal anastomosis was 6.4% (14/219 cases), a