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[肿瘤性左半结肠梗阻急诊治疗的手术风险评估:个人经验]

[Evaluation of operative risk in emergency treatment of neoplastic left colon obstruction: personal experience].

作者信息

Lorusso Curzio, Palazzo Paola, Merlicco Domenico

机构信息

Unità Operativa di Chirurgia Generale "A. De Blasi" D.A.C.T.I., Sezione di Chirurgia Generale e Toracica, Università degli Studi di Bari.

出版信息

Ann Ital Chir. 2005 Jul-Aug;76(4):353-5.

Abstract

AIM OF THE STUDY

To analyse the risk factors in the treatment of intestinal obstruction due to colorectal carcinoma. The treatment of neoplastic obstruction of the right colon until the splenic flexure is well defined: right hemicolectomy, enlarged right hemicolectomy. Otherwise the treatment of the obstruction due to left colon carcinoma beyond left flexure is not standardized.

MATERIAL AND METHODS

The Authors report on a consecutive series of 15 patients, classified according to Colorectal Tumours Emergencies Score (CTES), based on the analysis of 4 risks factors: colic, perforation, serum albumin, concurrent cardiovascular disease, chronic renal insufficiency. Each patient has been ranked in three classes of risk: low (CTES < 4), moderate (CTES 4-12), and high (CTES > 12).

CONCLUSIONS

Referring to this classification the Authors consider the choice of surgical treatment. When general conditions of the patient permit, it seems preferable to perform primary anastomosis.

摘要

研究目的

分析结直肠癌所致肠梗阻治疗中的危险因素。右半结肠癌至脾曲的肿瘤性梗阻的治疗已明确:右半结肠切除术、扩大右半结肠切除术。否则,左半结肠癌超过左曲所致梗阻的治疗尚无标准化方案。

材料与方法

作者报告了连续的15例患者,根据结直肠肿瘤急症评分(CTES)进行分类,该评分基于对4个危险因素的分析:绞痛、穿孔、血清白蛋白、并发心血管疾病、慢性肾功能不全。每位患者被分为三个风险等级:低(CTES<4)、中(CTES 4 - 12)、高(CTES>12)。

结论

参考此分类,作者考虑手术治疗的选择。当患者一般情况允许时,进行一期吻合似乎更可取。

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