老年结直肠癌合并肠梗阻的外科治疗体会

摘要

Objective To investigate the surgical treatment experience of senile colorectal cancer combined with intestinal obstruction, and to guide clinical diagnosis and improve the clinical effect. Methods A total of 56 cases of senile colorectal cancer combined with intestinal obstruction received different surgical treatment methods. There were 12 cases undergone ileocecal resection, 6 cases undergone right hemicolectomy, 14 cases undergone transverse colectomy, 5 cases undergone left hemicolectomy, 7 cases undergone sigmoid colectomy, and 12 cases undergone Miles’operation. Results There were 1 death case, 2 treatment abandoning cases, and 5 cases (8.9%) with wound infection. The remaining patients were cured. Up to now, the follow-up showed that 45 cases (84.9%) had mean survival period for more than 1 year after curative resection. Conclusion Early radical resection should be applied in senile colorectal cancer combined with intestinal obstruction, and postoperative active anti-infective therapy and adjuvant chemotherapy can reduce complications and improve survival rate.%目的：探讨老年结直肠癌合并肠梗阻的手术治疗体会，以指导临床诊断并提高临床疗效。方法56例老年结直肠癌合并肠梗阻患者，采用不同的手术方式治疗。其中行回盲部切除12例，右半结肠切除术6例，横向结肠切除术14例，左半结肠切除术5例，乙状结肠切除术7例， Miles’切除术12例。结果本组死亡1例，放弃治疗2例，有5例(8.9%)发生切口感染，其余患者均痊愈出院。随访至今，根治性切除手术平均生存期超过1年以上45例(84.9%)。结论老年结肠癌合并肠梗阻早期应争取根治性切除治疗，术后积极抗感染治疗和辅助化疗可减少术后并发症，提高患者生存率。