中国肿瘤外科杂志
中國腫瘤外科雜誌
중국종류외과잡지
CHINESE MEDICAL DIGEST SURGERY
2015年
2期
107-109
,共3页
苗战军%韩宗明%朱鸿波%张学贞
苗戰軍%韓宗明%硃鴻波%張學貞
묘전군%한종명%주홍파%장학정
结直肠癌%肠梗阻%诊断%手术治疗%吻合口瘘
結直腸癌%腸梗阻%診斷%手術治療%吻閤口瘺
결직장암%장경조%진단%수술치료%문합구루
colorectal cancer%intestinal obstruction%diagnosis%surgical treatment%anastomotic fistula
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。
目的：探討結直腸癌伴腸梗阻的診斷和手術治療。方法迴顧性分析開封市中心醫院2008年12月至2013年12月收治的76例結直腸癌伴腸梗阻的臨床資料,分析診斷方法、手術方式及預後。結果腹部CT檢查對結直腸癌伴腸梗阻的診斷率高于X線。右半結腸切除一期吻閤23例；左半結腸切除一期吻閤18例,其中6例行預防性迴腸末耑造瘺；35例直腸癌中,一期切除吻閤23例,一期切除吻閤加預防性橫結腸造瘺9例,3例無法切除行永久性乙狀結腸造瘺。術後髮生吻閤口瘺6例,死亡2例。結論腹部CT檢查對于確定腸梗阻的部位、性質有較高的臨床應用價值；右半結腸切除一期吻閤是安全可行的；在一定條件下,左半結腸切除及直腸癌切除後一期吻閤也是安全的；預防性造瘺可減少吻閤口瘺的髮生。
목적：탐토결직장암반장경조적진단화수술치료。방법회고성분석개봉시중심의원2008년12월지2013년12월수치적76례결직장암반장경조적림상자료,분석진단방법、수술방식급예후。결과복부CT검사대결직장암반장경조적진단솔고우X선。우반결장절제일기문합23례；좌반결장절제일기문합18례,기중6례행예방성회장말단조루；35례직장암중,일기절제문합23례,일기절제문합가예방성횡결장조루9례,3례무법절제행영구성을상결장조루。술후발생문합구루6례,사망2례。결론복부CT검사대우학정장경조적부위、성질유교고적림상응용개치；우반결장절제일기문합시안전가행적；재일정조건하,좌반결장절제급직장암절제후일기문합야시안전적；예방성조루가감소문합구루적발생。
Objective To investigate the diagnosis and surgical treatment of colorectal cancer with intesti-nal obstruction. Methods The clinical data of 76 cases of colorectal cancer with intestinal obstruction were ret-rospectively analyzed from Dec. 2008 to Dec. 2013,including analysis of diagnostic methods,the operation meth-od and prognosis. Results Accuracy of abdominal CT examination on diagnosing colorectal cancer with obstruc-tion is higher than that of X-ray. All patients received operation, 23 patients who suffered from right colon carci-noma were received primary resection and anastomosis;among 18 cases who suffered from left half colon carcino-ma, 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 re-ceived 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.
