Alekperov S F, Pugaev A V, Kalachev O A, Achkasov E E, Mel'nikov P V, Kanner D Iu
Khirurgiia (Mosk). 2012(11):38-44.
The study summarize the results of diagnostics and treatment of 536 patients aged 37-97 years with colon cancer stage II-IV, complicated by bowel obstruction. Patients with subcompensated and decompensated bowel obstruction prevailed. The dependence of the clinical picture from the tumor localization and the severity of the obstruction were identified. The authors pose that the decision about the median laparotomy needs the preoperative diagnosis of the obturative obstruction without verification of its causes. Decision about the delayed radical operation and minimizing the treatment to colon decompression should be based on additional diagnostic data (X-ray, irrigoscopy and colonoscopy). Surgical interventions with the median laparotomy showed the mortality rate of 30.7% and morbidity of 57.5%. The miniinvasive decompression of the colon reduces these rates to 1.8 and 7.1%, respectively.
该研究总结了536例年龄在37至97岁之间、患有II-IV期结肠癌并伴有肠梗阻的患者的诊断和治疗结果。以不完全代偿性和失代偿性肠梗阻患者为主。确定了临床表现与肿瘤定位及梗阻严重程度之间的相关性。作者认为，关于正中剖腹术的决策需要在未查明梗阻原因的情况下对闭袢性肠梗阻进行术前诊断。关于延迟根治性手术以及将治疗尽量减少至结肠减压的决策应基于额外的诊断数据（X线检查、灌肠造影和结肠镜检查）。正中剖腹术的外科干预显示死亡率为30.7%，发病率为57.5%。结肠微创减压分别将这些比率降至1.8%和7.1%。
