Kronborg O, Backer O, Sprechler M
Dis Colon Rectum. 1975 Jan-Feb;18(1):22-7. doi: 10.1007/BF02587233.
Results after operations for acute obstruction of the large intestine due to cancer were analyzed during a 10-year period and compared with the results after operations for nonobstructive tumors during the same period. The following conclusions could be deduced: 1) Cancer is more often obstructive in the colon than in the rectum. Cancers of the splenic flexure are relatively more often obstructive than cancers in other parts of the colon. 2) Postoperative morbidity (and probably mortality) is higher and the five-year survival shorter in patients with obstructive cancers of the large intestine than in those without obstruction. Obstructive Dukes' A tumors are very few. 3) The early morbidity and mortality after acute cecostomy are probably not higher than after acute transversostomy, if the cecostomy wound is left open. The cecostomy carries a risk of peritoneal contamination. 4) Cecostomy does not relieve obstruction in 5-10 per cent of the patients, while transversostomy seems always to be effective. Emergency exploratory laparotomy for obstructive cancer of the large bowel instead of a blind cecostomy reduces the number of patients who need two operations by 10 per cent. 5) Hernias are frequent at the sites of previous spontaneously closed cecostomies. 6) Antibiotic bowel preparation seems not to be effective shortly after decompressive colostomy.
对10年间因癌症导致大肠急性梗阻的手术结果进行了分析，并与同期非梗阻性肿瘤的手术结果进行了比较。可以得出以下结论：1）结肠癌比直肠癌更常导致梗阻。脾曲癌比结肠其他部位的癌症相对更常导致梗阻。2）大肠梗阻性癌症患者的术后发病率（可能还有死亡率）更高，五年生存率更低。梗阻性Dukes'A期肿瘤非常少见。3）如果盲肠造口伤口敞开，急性盲肠造口术后的早期发病率和死亡率可能不高于急性横结肠造口术后。盲肠造口有腹膜污染的风险。4）5%-10%的患者进行盲肠造口不能缓解梗阻，而横结肠造口似乎总是有效的。对于大肠梗阻性癌症进行急诊探查性剖腹手术而非盲目盲肠造口，可使需要进行两次手术的患者数量减少10%。5）在既往自发闭合的盲肠造口部位经常出现疝。6）减压结肠造口术后不久，抗生素肠道准备似乎无效。
