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目的 探讨减少右半结肠癌误诊误治 ,争取早期诊断与治疗。方法 分析本院 9年来收治的 6 3例右半结肠癌中有 46例均有误诊误治经过 ,误诊率为 73%。结果 因误诊误治造成 7例患者只能行结肠肿瘤姑息性切除术 ,3例行二期手术 ,另 3例因广泛转移无法手术 ,出院后 1～ 2个月内死亡。结论 掌握本病临床表现特点 ,详细询问病史 ,术前行钡灌摄片 ,以气钡双重造影为佳 ,必要时行 CT、B超检查 ;术中发现阑尾病变与临床表现不相符 ,应仔细探查回盲部、升结肠 ;对不能确诊结肠肿块 ,应行术中冰冻病理检查 ,可提高诊断率
Objective To explore the reduction of misdiagnosis and mistreatment of right colon cancer and strive for early diagnosis and treatment. Methods Sixty-three cases of right colon cancer treated in our hospital for 9 years were misdiagnosed and mistreated. The misdiagnosis rate was 73%. Results Because of misdiagnosis and mistreatment, 7 patients could only undergo palliative resection of colon tumor, 3 patients underwent secondary surgery, and the other 3 patients were inoperable due to extensive metastasis. They died within 1 to 2 months after discharge. Conclusion To master the clinical manifestations of the disease, ask the patient’s medical history in detail, preoperative radiographs are performed, and double-contrast angiography is better. If necessary, CT and B-ultrasound examinations are performed; the appendix lesions are found to be inconsistent with the clinical manifestations. Exploring the ileocecal region and ascending colon; for incurable colon masses, intraoperative frozen pathology should be performed to increase the diagnostic rate