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[1]于乐昌,寇 丽,尤胜义,等.左半结肠癌合并肠梗阻一期切除吻合可行性研究[J].天津医科大学学报,2014,20(06):456-458.
　YU Le-chang,KOU Li,YOU Sheng-yi,et al. Feasibility of one-stage resection and anastomosis in the treatment of left colon cancer with obstruction[J].Journal of Tianjin Medical University,2014,20(06):456-458.
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
20卷
期数:
2014年06期
页码:
456-458
栏目:
临床医学
出版日期:
2014-11-20

文章信息/Info

Title:

Feasibility of one-stage resection and anastomosis in the treatment of left colon cancer with obstruction

文章编号:
1006-8147（2014）06-0456-03
作者:
于乐昌; 寇 丽; 尤胜义; 马 涛; 张志远
（天津医科大学总医院普通外科，天津 300052）
Author(s):
 YU Le-chang;  KOU Li;  YOU Sheng-yi;  MA Tao;  ZHANG Zhi-yuan
(Department of General Surgery, General Hospital, Tianjin Medical University, Tianjin 300052, China)
关键词:
左半结肠癌; 肠梗阻; 一期切除吻合; Hartmann术; 局部肠腔灌洗
Keywords:
left colon cancer;  intestinal obstruction;  one-stage resection and anastomosis;  Hartmann procedure;  local intestine lavement
分类号:
R735. 3+5
DOI:
-
文献标志码:
A
摘要:
 目的：探讨左半结肠癌合并肠梗阻一期切除吻合的可行性。方法：回顾性分析331例左半结肠癌患者临床资料，其中95例合并肠梗阻，27例行一期切除吻合，68例行Hartmann手术，比较一期切除吻合组与Hartmann手术组临床疗效。结果：一期切除吻合组与Hartmann手术组相比，术后肺部感染、切口感染及尿路感染的发生率、围手术期死亡率、手术时间无显著性差异（P﹥0.05）；总住院时间及总住院费用明显低于后者（P＜0.05）。结论：左半结肠癌合并肠梗阻，在选取合适病例的基础上，经积极适当术前准备改善肠梗阻状态，术中合理有效的肠道减压及局部肠腔灌洗，行一期切除吻合是可行的。
Abstract:
Objective ：To investigate the feasibility of one-stage resection and anastomosis in the treatment of left colon cancer. Methods：The clinical data of 331 patients with colon cancer were analyzed retrospectively. Ninety five cases were with left colon cancer, among which 27 cases underwent stage one resection and anastomosis and 68 cases underwent Hartmann routine surgery. The clinical effects were compared between one-stage resection and anastomosis group and Hartmann surgery group. Results：One-stage resection and anastomosis group was compared with the Hartmann surgery group, with no significant difference in postoperative pulmonary infection, wound infection and urinary tract infections, perioperative mortality and operative time（P>0.05）. The length of hospitalization and total costs were significantly lower than the latter（P <0.05）. Conclusion：With Positive preoperative preparation, selection of the appropriate patients, reasonable and effective intestinal decompression, local lavement of the proximal and distal segment of colon, one-stage resection and anastomosis of left colon cancer is feasible.

参考文献/References:

[1]Kim H J, Choi G S, Park J S, et al. Higher rate of perineural invasion in stent-laparoscopic approach in comparison to emergent open resection for obstructing left-sided colon Cancer[J]. Int J Colorectal Dis, 2013,28(3):407

[2]Hsu T C. Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon[J]. Am J Surg, 2005,189(4):384

[3]孟凡亭. 左半结肠和直肠癌并急性肠梗阻的一期切除吻合治疗[J]. 中国普通外科杂志, 2009,18(10):1098

[4]Pasic F, Salkic N N. Predictive score for anastomotic leakage after elective colorectal Cancer surgery: a decision making tool for choice of protective measures[J]. Surg Endosc, 2013,27(10):3877

[5]Al S A, Fasih T, Hayat M. Use of self-expandable stents for obstructive distal and proximal large bowel Cancer:a retrospective study in a single centre[J]. J Gastrointest Cancer, 2010,41(1):43

[6]季加孚，步召德. 吻合器在直肠癌外科手术中的合理应用[J]. 中国实用外科杂志, 2007,27(6):451

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备注/Memo

备注/Memo:

作者简介 于乐昌 （1987-）， 男 ，硕士在读，研究方向：腹部外科危重症；通信作者：尤胜义， E-mail:13820099058@139.com。

更新日期/Last Update: 2014-12-02