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目的探讨急诊左半结肠癌急性梗阻一期切除吻合的可行性。方法回顾性分析36例左半结肠癌急性梗阻急诊手术的手术时机、术式选择及术中灌洗方法。结果 28例术中灌洗后一期切除吻合术,5例行结肠造瘘术,二期手术切除;1例行Hartmann术;2例行永久性结肠造瘘术。切口感染2例;吻合口瘘1例,为行一期切除吻合术患者;腹腔感染2例,全组无死亡病例。结论选择合适的病例,行左半结肠癌急性梗阻一期切除吻合是可行的,合理的围术期处理,术中彻底的结肠减压及灌洗,术中留置肛管,是手术成功的关键。
Objective To investigate the feasibility of a one-stage resection and anastomosis of acute obstruction of left colon cancer. Methods Retrospective analysis of 36 cases of acute rejection of left colon cancer emergency surgery operation timing, surgical options and intraoperative lavage method. Results 28 cases underwent laparoscopic resection and anastomosis, 5 cases underwent colostomy, and 2 cases underwent surgical resection. One patient underwent Hartmann operation and two patients underwent permanent colostomy. Incision infection in 2 cases; anastomotic fistula in 1 case, a line resection and anastomosis patients; 2 cases of abdominal infection, the whole group without deaths. Conclusion Choosing the right case, it is feasible to perform the first stage resection and anastomosis of the acute obstruction of the left colon cancer. Reasonable perioperative management, complete decompression and lavage of the colon during operation and indwelling the anal canal during operation are the keys to successful operation .