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本文报道198O年—1989年间532例左侧结直肠癌中并发急肠梗阻40例,1期切除14例(35%),Ⅱ期切除10例(25%),其他术式16例(40%).1期手术的五年存活率36.0%,Ⅱ期手术的五年存活率20.0%,Ⅰ期手术的吻合口漏3例,手术死亡1例,均发生在未行术中肠道灌洗的5例中;Ⅱ期切除木吻合口漏1例,无手术死亡.作者分析本组资料并结合文献认为,左侧结直肠癌并发急性肠梗阻应以急诊手术治疗为主,术前必须迅速纠正病人水电解质平衡,掌握好适应症.Ⅰ期切除吻合术中行全结肠灌洗是预防术后并发症的关键:
This article reported 532 cases of acute colorectal cancer complicated by acute intestinal obstruction between 198O and 1989, 14 cases of primary resection (35%), 10 cases of secondary resection (25%), 16 cases of other surgical methods (40% Five-year survival rate of 36.0% for stage 1 surgery, 20.0% for stage II surgery, 3 cases of anastomotic leak during stage I surgery, and 1 case of surgical death occurred during unoperated intestinal lavage Of the 5 cases, there was 1 case of anastomotic leak in stage II. There was no operative death. The authors analyzed the data in this group and combined the literature that acute intestinal obstruction on the left side of colorectal cancer should be treated with emergency surgery. Correcting the patient’s water-electrolyte balance and mastering the indications. Phase I resection and anastomosis is the key to prevent postoperative complications: