一期手术切除与重建在右半结肠癌并发肠梗阻中的应用

摘要

目的：探讨一期手术切除与重建在右半结肠癌并发肠梗阻中应用的治疗效果。方法：对45例右半结肠癌引起急性肠梗阻的患者行急诊手术治疗，结肠癌根治术后行回结肠一期吻合，记录患者的手术情况、术后情况、术后并发症情况和随访情况。结果：45例患者均手术顺利，平均手术时间（162.31±17.2）min，术中平均出血量（157.26±12.56）mL，术后平均排气时间（3.76±0.42）d，术后平均拆线时间（9.53±1.27）d，平均禁食（5.42±1.25）d。患者术后恢复良好，共发生并发症11例，其中6例出现肠管吻合口瘘，吻合口瘘经保守治疗后痊愈，3例切口感染，肺部和腹腔感染各1例。所有患者经一期手术切除与重建后生活质量较前均有明显提高（P<0.05）。结论：对右半结肠癌并发肠梗阻的患者行一期手术与重建的手术方法安全性高，术后患者恢复好，能明显提高患者生活质量，值得在临床上广泛使用。%Objective:To explore the effect of treatment of the application of primary surgical resection and reconstruction in right colorectal carcinoma combined with intestinal obstruction.Method:45 patients with right colorectal carcinoma combined with intestinal obstruction were conducted with the emergency surgical treatment,and did ileocolic anastomosis after the colon cancer radical resection. And then relevant information of patients’ operation,postoperative situation,complication were recorded and followed-up.Result:45 patients were operated successfully,and the average operation time was(162.31±17.2)min,the average amount of bleeding was(157.26±12.56)mL,the average postoperative exhaust time was(3.76±0.42)d,the average postoperative clearing time was(9.53±1.27)d,the average postoperative fasting time was(5.42±1.25)d. The patients recovered well,and complications occurred in 11 cases including 6 cases of intestinal anastomotic fistula,and recovered after conservative treatment of fistula. There were 3 cases of incision infection,and the lungs and abdominal infection were each 1 case. The quality of life for all patients were significantly improved after surgical resection and reconstruction(P<0.05).Conclusion:The primary surgical resection and reconstruction are of high operation safety for right colorectal carcinoma combined with intestinal obstruction,and can significantly improve the life quality of the patients. It’s worth to widely used in clinic.