Wilson R G, Gollock J M
J R Coll Surg Edinb. 1989 Feb;34(1):25-6.
Obstructing carcinomas of the left colon are traditionally managed with a staged resection, as immediate colonic anastomosis is associated with a high risk of anastomotic dehiscence. We have prospectively performed total or subtotal colectomy in 18 consecutive patients presenting with obstruction at or distal to the splenic flexure. The operative mortality was 11%, which compared favourably with the results of other methods of surgical management. The procedure is safe and no cases of anastomotic dehiscence occurred. Subtotal colectomy achieves in a single procedure relief of the obstruction, tumour resection and restoration of gut continuity whilst allowing resection of synchronous lesions and eliminating the risk of metachronous tumour. Frequent liquid stool was not a significant sequel of a subtotal colectomy in this series.
传统上，左半结肠癌梗阻采用分期切除治疗，因为立即进行结肠吻合术会导致吻合口裂开的高风险。我们前瞻性地对18例脾曲或其远端出现梗阻的连续患者进行了全结肠或次全结肠切除术。手术死亡率为11%，与其他手术治疗方法的结果相比更有利。该手术是安全的，未发生吻合口裂开病例。次全结肠切除术在一次手术中实现了梗阻解除、肿瘤切除和肠道连续性恢复，同时允许切除同步病变并消除异时性肿瘤的风险。在本系列中，频繁的稀便并非次全结肠切除术的显著后遗症。
