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目的探讨左半结肠癌并肠梗阻手术中采用双向封闭式顺行灌肠法,以提高术中Ⅰ期吻合率,防止吻合口瘘的发生。方法将1999年6月至2003年6月收治的左半结肠癌并肠梗阻需行急诊手术62例病人随机分为两组。观察组31例,术中均采用双向封闭式顺行灌肠法及Ⅰ期切除吻合术。对照组31例,术中实施传统的开放减压、局部冲洗、如有可能行肿瘤切除、肠外置,术后1～2个月再行Ⅱ期肠造瘘口关闭。结果观察组均行Ⅰ期左半结肠癌切除吻合术,未生吻合口漏,术后病人恢复良好。结论术中采用双向封闭式顺行灌肠法,使左半结肠癌并肠梗阻Ⅰ期切除肿瘤及吻合术成为可行。
Objective To investigate the use of two-way closed antegrade enema in the treatment of left colon cancer and intestinal obstruction to improve the rate of primary anastomosis and prevent the occurrence of anastomotic fistula. Methods Sixty-two patients undergoing emergency surgery for left-sided colon cancer and intestinal obstruction admitted from June 1999 to June 2003 were randomly divided into two groups. In the observation group, 31 cases were treated with two-way closed antegrade enema and stage Ⅰ resection and anastomosis. Control group of 31 cases, intraoperative implementation of the traditional open decompression, local irrigation, if possible tumor resection, outside the bowel, 1 to 2 months after the reoperation Ⅱ stage ostomy closed. Results The observation group underwent resection and anastomosis of the first stage of the left colon cancer, without anastomotic leakage, postoperative patients recovered well. Conclusion Intraoperative use of two-way closed antegrade enema, the first half of colon cancer with intestinal obstruction and resection of the tumor and anastomosis become feasible.