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目的:回顾性分析比较左半结肠癌急性梗阻一期手术与同期左半结肠癌根治术患者的手术临床资料,探讨左半结肠癌急性梗阻一期手术的可行性。方法:回顾性将我中心2004年1月至2007年3月收治的59例左半结肠癌急性梗阻一期手术病例分为A组,将同期226例左半结肠癌根治术病例分为B组,比较两组之间清除淋巴结数、术后进食时间、吻合口漏发生率、肺部感染率、切口感染率、住院时间、复发和转移率。结果:在上述观察指标中,在A组分别为(13.3±1.8)枚,(3.6±0.9)d,1/59(1.69%),4/59(6.78%),2/59(3.39%),(12.4±0.9)d,6/59(10.17%);B组分别为12.8±1.5,3.2±0.8,1/226(0.44%),8/226(3.54%),6/226(2.65%),11.7±1.5,23/226(10.62%);经统计学处理,两组间没有显著性差异。结论:术中合理应用结肠灌洗,良好的手术技巧,术后积极辅助治疗,左半结肠癌急性梗阻一期手术是安全可行的,可避免二次手术带给患者的痛苦,术后并发症也无明显增加。
OBJECTIVE: To retrospectively analyze the clinical data of patients with acute primary obstruction of left colon cancer and the patients undergoing radical resection of left-sided colon cancer treated with the same period and to explore the feasibility of primary surgery for acute obstruction of left-sided colon cancer. Methods: A retrospective analysis of 59 cases of acute primary obstruction of left colon cancer treated in our center from January 2004 to March 2007 were divided into group A, 226 patients with left colon cancer underwent radical resection were divided into group B The number of lymph nodes, postoperative eating time, anastomotic leakage rate, lung infection rate, incision infection rate, hospitalization time, recurrence and metastasis rate were compared between the two groups. Results: Among the above indexes, there were 13.3 ± 1.8 (3.6 ± 0.9) d, 1/59 (1.69%), 4/59 (6.78%) and 2/59 , (12.4 ± 0.9) d and 6/59 (10.17%) in group B respectively, while those in group B were 12.8 ± 1.5,3.2 ± 0.8,1 / 226 (0.44%), 8/226 ), 11.7 ± 1.5,23 / 226 (10.62%). There was no significant difference between the two groups after statistical analysis. Conclusions: Intraoperative colonic lavage, good surgical techniques and active postoperative adjuvant therapy are the safe and feasible procedures for the first stage of acute obstruction of left colon cancer, which can avoid the pain brought by secondary surgery and postoperative complications No significant increase.