Stone J M, Bloom R J
Division of General Surgery, Veterans Administration, Palo Alto, California 94304.
Dis Colon Rectum. 1989 May;32(5):429-31. doi: 10.1007/BF02563698.
Complete colonic obstruction secondary to colorectal cancer has traditionally been managed by a staged approach. Simple diversion or resection with colostomy is performed followed by reestablishment of intestinal continuity at a subsequent operation. The use of a transendoscopic technique of balloon dilatation for complete malignant obstruction in the management of three patients is discussed. Successful balloon dilatation allowed for complete bowel preparation and either elective single-stage resection or controlled Nd:YAG laser palliation in a clean field. Although not applicable to all clinical situations, balloon dilatation is a valuable adjunct in the management of obstructing colorectal cancer. Relief of obstruction by tumor dilatation allows 1) correction of fluid and electrolyte abnormalities, 2) administration of a complete bowel preparation, 3) single-stage resection and anastomosis, or 4) palliative laser photoablative therapy that avoids the need for colostomy.
结直肠癌继发的完全性结肠梗阻传统上采用分期治疗方法。先进行简单的转流或结肠造口切除术，随后在后续手术中重建肠道连续性。本文讨论了使用经内镜球囊扩张技术治疗3例完全性恶性梗阻的情况。成功的球囊扩张使得能够进行充分的肠道准备，并在清洁术野中进行择期一期切除或可控的钕:钇铝石榴石激光姑息治疗。尽管球囊扩张并不适用于所有临床情况，但它在梗阻性结直肠癌的治疗中是一种有价值的辅助手段。通过肿瘤扩张解除梗阻可实现以下几点：1) 纠正水电解质异常；2) 进行充分的肠道准备；3) 一期切除和吻合；或4) 避免结肠造口的姑息性激光光凝治疗。
