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1987年1月至1996年12月收治左半结肠癌致急性肠梗阻23例,其中18例行一期肿瘤切除吻合术,术中全部行结肠减压灌洗,无吻合口瘘,另5例行一期肿瘤切除,2~3周后再行结肠端端吻合术,1例并发吻合口瘘,经及时处理后痊愈出院。认为左半结肠癌所致的急性肠梗阻的病人,只要选择好手术适应证,术中肠道减压灌洗,吻合断端的良好血运及无张力,减压肛管,腹腔引流管,围手术期加强营养支持及抗感染的应用是预防和及时处理吻合口瘘的关键。如术中发现不能行一期吻合的,也尽量先将肿瘤一期切除,以免失去手术机会。
From January 1987 to December 1996, 23 cases of acute intestinal obstruction caused by left-sided colon cancer were treated. Of these, 18 cases underwent one-stage tumor resection and anastomosis. All patients underwent colon decompression and lavage without anastomotic leakage, and the other 5 cases. One-stage tumor resection was performed, and anastomosis of the colon was performed 2 to 3 weeks later. Anastomotic fistula occurred in 1 patient. He was discharged after being treated in time. Patients with acute bowel obstruction caused by left colon cancer should be considered as long as they have good surgical indications, intraoperative intestinal decompression and lavage, good blood supply and no tension at the anastomosis, anal decompression, and abdominal drainage tube. Perioperative strengthening nutrition support and anti-infection application is the key to prevention and timely treatment of anastomotic leakage. If it is found that intraoperative anastomosis cannot be performed during surgery, the tumor should be first removed as soon as possible to avoid losing the operation.