目的:探讨老年结直肠癌并急性肠梗阻的处理原则和方法。方法:回顾性分析10年间收治的78例(70~80岁)结直肠癌并急性肠梗阻的临床资料。78例中Dukes B期20例,C期18例,D期40例。全部患者经手术治疗,包括急诊手术46例,择期性手术32例。采用右半结肠一期切除肠吻合治疗30例,左半结肠一期切除吻合40例。Hartmann 5例, Di×on手术2例,肿瘤近端肠管造瘘1例。结果:术后出现并发症16例(20.5%)21例次,包括切口感染14例次,腹腔感染5例次和吻合口瘘2例次,死亡3例(3.85%),75例(96.2%)痊愈出院。结论:对于急性结直肠癌性梗阻除非有急诊手术指征,应首先采用非手术治1~2 d,尽可能转为择期手术;一期切除吻合治疗结直肠癌并发急性梗阻,是方便可行而安全有效的方法,加强围手术期处理是手术成功的关键。
Citation:
HE Ao,WU Jianping,WANG Fandong.. The Treatment of Colorectal Carcinoma With Acute Colonic Obstruction in the Elderly: A Report of 78 Cases. West China Medical Journal, 2009, 24(8): 1956-1958. doi:
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- 1. KOU LJ,LEU SY, LIU MC,et al. How aggressive should we be in patients with stage IV colorectal cancer ?[J]. Dis Colon retum,2003,6(11):1646-1652.
- 2. 楼文晖,秦新裕.城市老年人和成年人急性肠梗阻的病因及治疗分析[J].中华胃肠外科杂志,2001,4(1):37-39.
- 3. DE AGULIARNASCIMENTO JE, CAPOROSSI, NASCIMENTO M.comparison beween resection and primary anatomosis and staged resectinon in obstructing adenocanrcinoma of the left colon[J].Arg Gastoenterol,2002,39(4):245.
- 4. 曹志兴, 杨佳永 周绍裳,高龄结.直肠癌病人的围手术期处理[J].中华外科杂志,2004,24(2):107-108.
- 5. 孙勇.70岁以上结直肠癌患者围手术期处理[J].中国肛肠癌杂志,2007,27(4):16-18.