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[结肠肿瘤手术中的紧急情况。文献综述及作者病例]

[Emergencies in the surgery of colonic neoplasms. A review of the literature and the authors' cases].

作者信息

Viale A, Ghisotti E, Ferraris C, Anselmetti G C

机构信息

II Divisione Chirurgica, USSL n. 3, Ospedale Martini, Torino.

出版信息

Minerva Chir. 1991 Jan;46(1-2):25-30.

PMID:2034372
Abstract

The paper reports the personal experience of the 2nd Division of General Surgery of the Martini Hospital in Turin and compares it to the results of the most recently published studies. Of 123 patients who underwent emergency surgery, 101 were suffering from tumors of the colon complicated by intestinal occlusion and 22 by perforation. Only right hemicolectomy was performed in cases of perforation or resection with ileostomy and colic mucous fistula was used for neoplasms located in the right colon; Hartmann's operation or dual ostomy was performed in the event of neoplasms in the left colon. Surgical treatment of occlusive tumors of the left colon is still the subject of continued debate. The elective surgical technique is an amblée resection using colo-colic anastomosis with a protective ostomy. This is followed by Hartmann's operation, whereas decompressive colostomy should only be used in patients who are admitted to hospital in generally precarious conditions.

摘要

该论文报告了都灵马蒂尼医院普通外科第二科室的个人经验,并将其与最近发表的研究结果进行了比较。在123例接受急诊手术的患者中,101例患有结肠肿瘤并伴有肠梗阻,22例伴有穿孔。穿孔病例仅行右半结肠切除术,或行切除加回肠造口术,右半结肠肿瘤采用结肠黏液瘘;左半结肠肿瘤则行哈特曼手术或双造口术。左半结肠闭塞性肿瘤的外科治疗仍是持续争论的主题。择期手术技术是采用结肠-结肠吻合术并加保护性造口的扩大切除术。其次是哈特曼手术,而减压结肠造口术仅应用于入院时一般情况不稳定的患者。

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