Yu B M
Zhonghua Wai Ke Za Zhi. 1989 Jul;27(7):285-6, 443.
In the past 30 years 338 patients with colorectal carcinoma were admitted for acute intestinal obstruction which accounted for 17.17% of 1969 surgically treated colorectal carcinomas. Of these, right colon carcinoma was found in 116 cases, left colon carcinoma in 177, and rectal carcinoma in 45. Sixty nine one-stage resections of the tumor out of 148 emergent operations were carried out including all 29 right colon carcinomas, 20 out 34 left colon carcinomas, and 4 out of 6 rectal carcinomas. In patients undergoing one-stage resections, the overall operative mortality was 3.77%, morbidity happened in one case suffering from anastomotic leakage, and the five year survival rate was 43.4% compared with no operative mortality, and five year survival of only 18.75% in delayed resection group. Our data showed that the mortality of one stage resection of left colon carcinomas complicated with acute obstruction was acceptable and the five year survival rate was slightly higher than that in delayed resection. In terms of whole series, the five year survival rate in one stage resection group was significantly higher than that in delayed resection group. The authors, therefore, favour one stage resection of the tumor in cases of acute intestinal obstruction.
在过去30年中，338例结直肠癌患者因急性肠梗阻入院，占1969例接受手术治疗的结直肠癌患者的17.17%。其中，右结肠癌116例，左结肠癌177例，直肠癌45例。148例急诊手术中有69例进行了肿瘤一期切除，包括所有29例右结肠癌、34例左结肠癌中的20例以及6例直肠癌中的4例。在接受一期切除的患者中，总体手术死亡率为3.77%，1例发生吻合口漏，五年生存率为43.4%；而延迟切除组无手术死亡，五年生存率仅为18.75%。我们的数据表明，左结肠癌合并急性梗阻一期切除的死亡率是可以接受的，五年生存率略高于延迟切除组。就整个系列而言，一期切除组的五年生存率显著高于延迟切除组。因此，作者主张对急性肠梗阻病例进行肿瘤一期切除。
