目的:探討老年結直腸癌并急性腸梗阻的處理原則和方法。方法:回顧性分析10年間收治的78例(70～80歲)結直腸癌并急性腸梗阻的臨床資料。78例中Dukes B期20例,C期18例,D期40例。全部患者經手術治療,包括急診手術46例,擇期性手術32例。采用右半結腸一期切除腸吻合治療30例,左半結腸一期切除吻合40例。Hartmann 5例, Di×on手術2例,腫瘤近端腸管造瘺1例。結果:術后出現并發癥16例(20.5%)21例次,包括切口感染14例次,腹腔感染5例次和吻合口瘺2例次,死亡3例(3.85%),75例(96.2%)痊愈出院。結論:對于急性結直腸癌性梗阻除非有急診手術指征,應首先采用非手術治1～2 d,盡可能轉為擇期手術;一期切除吻合治療結直腸癌并發急性梗阻,是方便可行而安全有效的方法,加強圍手術期處理是手術成功的關鍵。
Citation：
HE Ao,WU Jianping,WANG Fandong.. The Treatment of Colorectal Carcinoma With Acute Colonic Obstruction in the Elderly: A Report of 78 Cases. West China Medical Journal, 2009, 24(8): 1956-1958. doi:
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- 1. KOU LJ,LEU SY, LIU MC,et al. How aggressive should we be in patients with stage IV colorectal cancer ?[J]. Dis Colon retum,2003,6(11):1646-1652.
- 2. 樓文暉,秦新裕.城市老年人和成年人急性腸梗阻的病因及治療分析[J].中華胃腸外科雜志,2001,4(1):37-39.
- 3. DE AGULIARNASCIMENTO JE, CAPOROSSI, NASCIMENTO M.comparison beween resection and primary anatomosis and staged resectinon in obstructing adenocanrcinoma of the left colon[J].Arg Gastoenterol,2002,39(4):245.
- 4. 曹志興, 楊佳永 周紹裳,高齡結.直腸癌病人的圍手術期處理[J].中華外科雜志,2004,24(2):107-108.
- 5. 孫勇.70歲以上結直腸癌患者圍手術期處理[J].中國肛腸癌雜志,2007,27(4):16-18.
