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不进行术中灌洗的梗阻性左侧结肠和直肠肿瘤一期切除

[Primary resection of obstructive left-sided colon and rectal tumors without intraoperative lavage].

作者信息

Lengyel L, Szakáts T, Kóti C

机构信息

Területi Kórház Berettyóújfalu, Sebészeti Osztály.

出版信息

Orv Hetil. 2001 Dec 2;142(48):2681-5.

Abstract

Of the study is to show the results of early postoperative period of left-sided large bowel obstruction (LBO) and methods of decompression without colonic lavage and primary resection. Retrospective analysis of 28 patients admitted to the Surgical Department with LBO between years 1996 and 2000 were treated with ortograde decompression, and primary resection without on table colonic lavage. The surgical method, complications and mortality are pointed out. The patients average age were 71 +/- 9.7 years and only one was free of comorbidity. The average time of operative interventions was 116 +/- 42 minutes. 9 patients out of 28 had rectum cancer their anastomosis were made by instrumental way and the others by hand. The bowel movement was restored (in 89%) on the fourth day of operation. Surgical complications were observed at 3/28 patients (10.7%), and non surgical complication at three patients. Mortality rate 3.5%, one patient was lost. The average hospital stay was 12 +/- 5 days, 70% of the patients were at home within 11 days. The emergency surgical treatment of left-sided colonic obstruction caused by cancer treated by ortograde decompression and primary resection without colonic lavage is a safe method in experienced surgeon hand. The patients have a short recovery period and better quality of life.

摘要

本研究旨在展示左侧大肠梗阻(LBO)术后早期的结果,以及不进行结肠灌洗和一期切除的减压方法。对1996年至2000年间收治于外科的28例LBO患者进行回顾性分析,这些患者接受了顺行减压和不进行术中结肠灌洗的一期切除治疗。指出了手术方法、并发症和死亡率。患者平均年龄为71±9.7岁,仅有1例无合并症。手术干预的平均时间为116±42分钟。28例患者中有9例患有直肠癌,其吻合术通过器械方式进行,其余通过手工进行。术后第四天肠道功能恢复(89%)。28例患者中有3例(10.7%)出现手术并发症,3例出现非手术并发症。死亡率为3.5%,1例患者死亡。平均住院时间为12±5天,70%的患者在11天内出院。对于由癌症引起的左侧结肠梗阻,采用顺行减压和不进行结肠灌洗的一期切除进行急诊手术治疗,在经验丰富的外科医生手中是一种安全的方法。患者恢复时间短,生活质量更好。

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