Kristiansen V B, Sørensen C, Kjaergaard J, Jensen H E
Bispebjerg Hospital, København, kirurgisk gastroenterologisk afdeling F.
Ugeskr Laeger. 1990 Jan 8;152(2):101-3.
During a period of 17 years, 135 patients with acute left-sided obstructive cancer of the colon were admitted to two hospitals in the County of Copenhagen. Primary decompression by means of coecostomy was performed. The plan was to perform resection of the tumour after some weeks and colocolic anastomosis and closure of the coecostomy either spontaneously or operatively after some months. The total mortality was 24%. A total of 84 patients (62%) completed the planned therapeutic course, 21 without complications. Eighteen patients survived with permanent coecostomies. The mortality in this material was similar to those in materials where other therapeutic regimes were employed. The prolonged therapeutic programme and considerable morbidity thus do not result in reduction in the mortality. The authors cannot therefore recommend primary decompressive coecostomy. This method can only be recommended as an emergency measure under local anaesthesia for patients in such poor general condition that other forms of treatment are not possible.
在17年的时间里，135例急性左侧结肠癌梗阻患者被收治到哥本哈根县的两家医院。采用盲肠造口术进行初步减压。计划是在几周后进行肿瘤切除，数月后进行结肠结肠吻合术，并自行或通过手术关闭盲肠造口。总死亡率为24%。共有84例患者（62%）完成了计划的治疗过程，其中21例无并发症。18例患者存活并带有永久性盲肠造口。该资料中的死亡率与采用其他治疗方案的资料相似。因此，延长的治疗方案和相当高的发病率并未导致死亡率降低。因此，作者不推荐采用初步减压性盲肠造口术。这种方法仅可作为在局部麻醉下对一般状况极差、无法采用其他治疗方式的患者的一种紧急措施。
