Lin Bing-Qiang, Wang Rong-Lin, Li Qing-Xiang, Chen Wen, Huang Zheng-Yuan
Department of Emergency Surgery, Union Hospital of Fujian Medical University, Fuzhou, China.
J BUON. 2015 May-Jun;20(3):756-61.
The aim of this study was to explore the treatment strategies for patients with obstructive colorectal cancer at different sites.
Treatment strategies were adopted according to the location of colorectal cancer and the condition of the patients when they were admitted to the hospital. Among a total of 134 patients, 29 patients were subjected to stent placement to relieve the obstruction before undergoing colorectal resection, 15 patients underwent per anum ileus catheterization to alleviate the symptoms of obstruction and waited for removal of the tumor within a limited time; 39 underwent intraoperative colonic lavage and colon resection with anastomosis and the remaining 51 patients were subjected to emergency surgery due to strangulation of the bowel, perforation, septic shock or other conditions before surgery.
Stent placement was successfully performed on 23 patients, with a success rate of 79%. Ninety-five of 134 patients (71% had stage I anastomosis and only one case had anastomotic fistula. Infection of incision happened in 9 (7%) cases and 2 (1.5%) patients died of infection.
Individualized treatment for patients with obstructive colorectal cancer can lead to tumor resection and stage I anastomosis, thereby avoiding the suffering of second-stage surgery or colostomy.
本研究旨在探讨不同部位梗阻性结直肠癌患者的治疗策略。
根据结直肠癌的位置及患者入院时的病情采取治疗策略。在总共134例患者中，29例患者在进行结直肠切除术前接受了支架置入以缓解梗阻，15例患者进行了经肛门肠梗阻导管置入以缓解梗阻症状并在有限时间内等待肿瘤切除；39例患者接受了术中结肠灌洗及结肠切除吻合术，其余51例患者因肠绞窄、穿孔、感染性休克或其他手术前情况而接受了急诊手术。
23例患者成功进行了支架置入，成功率为79%。134例患者中有95例（71%）进行了一期吻合，仅有1例发生吻合口瘘。9例（7%）发生切口感染，2例（1.5%）患者死于感染。
梗阻性结直肠癌患者的个体化治疗可实现肿瘤切除及一期吻合，从而避免二期手术或结肠造口的痛苦。
