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目的:探讨左半结直肠癌并急性肠梗阻经内镜介入治疗后再限期行肿瘤根治切除及一期肠吻合术的临床应用价值。方法:回顾性分析2006年-2011年我院收治的87例左半结直肠癌并急性肠梗阻的临床资料。结果:本组87例中,71例经内镜置入支架或肠梗阻导管介入减压治疗成功并完成了肿瘤根治性切除及一期肠吻合术。16例介入治疗失败行了急诊手术治疗,其中支架或导管置入失败7例,堵塞5例,减压效果差4例,无穿孔、出血并发症,介入治疗有效率81.6%。限期手术后切口感染5例(7.0%);急诊手术后切口感染4例(25.0%);吻合口漏2例(2.8%);无死亡病例发生。结论:左半结直肠癌并急性肠梗阻经内镜介入治疗后,限期行肿瘤根治性切除及一期肠吻合术,可以最大限度降低术后切口感染、吻合口漏机率,值得临床推广应用。
Objective: To investigate the clinical value of radical mastectomy and primary anastomosis in patients with left-sided colorectal cancer and acute intestinal obstruction after endoscopic interventional treatment. Methods: The clinical data of 87 cases of left-sided colorectal cancer with acute intestinal obstruction admitted from 2006 to 2011 in our hospital were retrospectively analyzed. Results: Of 87 cases in this group, 71 cases were successfully treated by endoscopic placement of stents or ileus after catheterization and complete radical resection and one-stage enterostomy. Sixteen cases failed to receive emergency operation in interventional treatment. Among them, stent or catheter failed in 7 cases, occlusion in 5 cases and decompression in 4 cases, without perforation and bleeding complications. The intervention rate was 81.6%. Five patients (7.0%) had incisional wound infection after operation. Four patients (25.0%) had incision infection after emergency operation and two patients (2.8%) had anastomotic leakage. No deaths occurred. Conclusions: After endoscopic interventional treatment of left-sided colorectal cancer with acute intestinal obstruction, radical resection of the tumor and anastomosis of the intestine during a definite period can minimize the incision infection and anastomotic leakage rate after operation, which is worthy of clinical application.