摘要
目的探讨结直肠癌伴肠梗阻的诊断和手术治疗。方法回顾性分析开封市中心医院2008年12月至2013年12月收治的76例结直肠癌伴肠梗阻的临床资料,分析诊断方法、手术方式及预后。结果腹部CT检查对结直肠癌伴肠梗阻的诊断率高于X线。右半结肠切除一期吻合23例;左半结肠切除一期吻合18例,其中6例行预防性回肠末端造瘘;35例直肠癌中,一期切除吻合23例,一期切除吻合加预防性横结肠造瘘9例,3例无法切除行永久性乙状结肠造瘘。术后发生吻合口瘘6例,死亡2例。结论腹部CT检查对于确定肠梗阻的部位、性质有较高的临床应用价值;右半结肠切除一期吻合是安全可行的;在一定条件下,左半结肠切除及直肠癌切除后一期吻合也是安全的;预防性造瘘可减少吻合口瘘的发生。
Objective To investigate the diagnosis and surgical treatment of colorectal cancer with intestinal obstruction. Methods The clinical data of 76 cases of colorectal cancer with intestinal obstruction were retrospectively analyzed from Dec. 2008 to Dec. 2013,including analysis of diagnostic methods,the operation method and prognosis. Results Accuracy of abdominal CT examination on diagnosing colorectal cancer with obstruction is higher than that of X-ray. All patients received operation, 23 patients who suffered from right colon carcinoma were received primary resection and anastomosis;among 18 cases who suffered from left half colon carcinoma, 6 cases received preventive terminal ileostomy, the rest cases received primary resection and anastomosis;among 35 cases suffered from rectal cancer,23 cases received primary resection and anastomosis,9 cases received preventive transverse colostomy, 3 cases received permanent sigmoid colostory. Postoperative anastomotic fistula occurred among 6 cases, 2 cases died. Conclusions Abdominal CT scan has high clinical application value owing to its location intestinal obstruction and its nalure. The right colon resection one stage anastomosis is safe and feasible;one-stage resection and primary anastomos is safe in the left half colon and rectal carcinoma under certain conditions;preventive colostomy can reduce the occurrence of anastomotic fistula.
出处
《中国肿瘤外科杂志》
CAS
2015年第2期107-109,共3页
Chinese Journal of Surgical Oncology
关键词
结直肠癌
肠梗阻
诊断
手术治疗
吻合口瘘
colorectal cancer
intestinal obstruction
diagnosis
surgical treatment
anastomotic fistula
