Holzer B, Schiessel R
Chirurgische Abteilung, Sozialmedizinisches Zentrum Ost/Donauspital, Wien, Osterreich.
Chirurg. 2001 Aug;72(8):905-9. doi: 10.1007/s001040170086.
Ileus due to a colorectal carcinoma is still an illness with high mortality currently between 15 and 20%. Advanced tumor stages are found in the majority of the patients. Today one-staged procedures are preferred, although a clear advantage in postoperative mortality was not proven so far. We recommend a concept, depending on localization, general condition and tumor stage. For patients in very bad general condition a primary colostomy is still a good option today. In case of a damaged intestine we recommend either a two-staged procedure with primary resection and colostomy and secondary closure of the stoma or a subtotal colectomy in patients who are in a good general condition. For patients in very good condition an one-staged procedure should be performed, whereby we prefer the resection with on table lavage.
结直肠癌所致肠梗阻目前仍是一种死亡率较高的疾病，死亡率在15%至20%之间。大多数患者处于肿瘤晚期。如今，一期手术更为可取，尽管目前尚未证实其在术后死亡率方面具有明显优势。我们建议根据病变部位、一般状况和肿瘤分期制定治疗方案。对于一般状况很差的患者，一期结肠造口术如今仍是一个不错的选择。如果肠管受损，对于一般状况良好的患者，我们建议采用一期切除并造口、二期关闭造口的两期手术，或者行次全结肠切除术。对于一般状况非常好的患者，应进行一期手术，我们更倾向于术中灌洗后切除。
