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急诊次全结肠切除术在左半结肠癌性梗阻中的作用

[Role of emergency subtotal colectomy in neoplastic obstructions of the left colon].

作者信息

Patel J C, Renier J F, De Cervens T, Hardy C, Favas A, Boukris T, Orzelski Y, Candau P, Guesnon P

机构信息

Service de Chirurgie, Hôpital Ambroise-Paré, Boulogne.

出版信息

Chirurgie. 1991;117(4):329-32.

PMID:1817829
Abstract

From 1984 to 1990, 60 patients underwent emergent surgery for a neoplastic obstruction of the left colon. We performed 19 colostomies without initial exeresis and 41 immediate tumoral resections. In the latter group, five subtotal colectomies (S.T.C.) were performed, including four with immediate mechanical anastomosis. Two patients had synchronous cancers and three had pre-perforating cecal lesions. Three patients had an associated general peritonitis. Three of the patients treated with STC died. These were these patients with general peritonitis, two of whom also had hepatic metastases. The data found in the literature on neoplastic obstructions of the left colon treated with STC with immediate anastomosis (227 cases are published) show an overall mortality rate of 8.4% with 24% morbidity, a complication of the anastomosis occurring in 4.5% of all cases.

摘要

1984年至1990年期间,60例患者因左半结肠癌性梗阻接受了急诊手术。我们进行了19例未先行切除的结肠造口术和41例即刻肿瘤切除术。在后一组中,进行了5例次全结肠切除术(S.T.C.),其中4例次进行了即刻机械吻合。2例患者为同时性癌,3例患者有盲肠穿孔前病变。3例患者伴有弥漫性腹膜炎。接受全结肠切除术治疗的3例患者死亡。这些患者均患有弥漫性腹膜炎,其中2例还伴有肝转移。文献中关于即刻吻合的全结肠切除术治疗左半结肠癌性梗阻的数据(已发表227例)显示,总死亡率为8.4%,发病率为24%,吻合口并发症发生率为4.5%。

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