Hartmann 手术治疗结直肠癌的临床效果分析

摘要

目的：探讨 Hartmann 手术治疗结直肠癌的临床效果。方法：回顾分析2006年6月—2013年12月在复旦大学附属中山医院行 Hartmann 手术的63例结直肠癌患者的临床资料。结果：63例患者均顺利完成手术，其中择期手术50例，急诊手术13例。手术时间平均（170．2±44．0）min，术中失血量平均（93．3±38．8）mL，平均住院天数（16．4±10．6）d。术后30 d 内12例出现并发症，其中切口感染6例，造瘘口感染1例，结肠残端感染1例，心衰1例，肾功能不全1例，黏连性肠梗阻2例。42例患者获得随访，随访时间为8～66个月；14例随访5年以上，其中4例生存5年以上，5年生存率为28．6％。结论：Hart-mann 手术仍是治疗结直肠癌的安全有效的术式，可有效改善患者生存质量，延长患者的生存时间。%Objective:To investigate the clinical efficacy of Hartmann′s procedure on colorectal cancer.Methods:The clinical data of 63 patients with colorectal cancer who underwent Hartmann′s procedure from Jun 2006 to Dec 2013 were retrospectively analyzed.Results:All the 63 patients were successfully performed Hartmann′s procedure,of which 50 cases were elective and 13 cases were emergent.The average duration of operation was 170 min.The average volume of intra-operative blood loss was 90 mL.The average duration of hospital stay was 16 d.Postoperative complications within 30 days occurred in 17 patients,of which 6 cases were surgical infection,1 case was stoma infection,1 case was colon stump infection,1 case was heart failure,1 case was renal insufficiency,2 cases were adhesive ileus.Among the 63 cases,42 patients were followed up for 8 to 66 months. Fourteen cases were followed up for more than five years,of which 4 patients survived more than 5 years,and the 5-year sur-vival rate was 28.6%.Conclusions:Hartmann′s procedure is still a safe and effective surgical procedure in the treatment of colorectal cancer.It can effectively improve the quality of life and prolong survival time of patients.