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目的在损伤控制性外科理念指导下,探讨老年梗阻性直肠癌的合理处理方式。方法山西省人民医院结直肠肛门外科2006年1月至2009年6月收治老年梗阻性直肠癌病人20例,在损伤控制性外科理念的指导下,回顾性分析病人分阶段、分步骤处理的临床资料。结果 18例经过分阶段、分步骤的围手术期处理,肠梗阻症状缓解,并进行了限期确定性手术治疗。2例病人急诊手术造口。确定性手术后痊愈17例,1例发生吻合口瘘,经回肠末端造口后治愈。结论对于老年梗阻性直肠癌的病人,在损伤控制性外科理念的指导下,术前暂时缓解肠梗阻症状,变急诊手术为限期手术,可以提高一期手术成功率,明显改善病人预后。
Objective To investigate the reasonable treatment of obstructive rectal cancer in the elderly under the guidance of the concept of controlled surgery. Methods Colorectal and Anal Surgery, People's Hospital of Shanxi Province From January 2006 to June 2009, 20 patients with obstructive rectal cancer in the elderly were enrolled. Under the guidance of the concept of controlled surgery of injury, the clinical data of patients with stage-by-step and step-by-step treatment data. Results Eighteen patients underwent stage-by-stage perioperative management with relief of intestinal obstruction and definite definitive surgery. Two patients underwent emergency surgical stoma. 17 cases were cured after definitive surgery, 1 case had anastomotic fistula and were cured after the terminal ileum stoma. Conclusions For elderly patients with obstructive rectal cancer under the guidance of the concept of controlled surgery for injury, preoperative temporary relief of intestinal obstruction symptoms, emergency surgery for a period of surgery, can improve the success rate of a surgery and significantly improve the prognosis of patients.