Badía J M, Sitges-Serra A, Pla J, Ragué J M, Roqueta F, Sitges-Creus A
Department of Surgery, Hospital Nostra Senyora del Mar, Universitat Autònoma de Barcelona, Spain.
Int J Colorectal Dis. 1987 Nov;2(4):187-9. doi: 10.1007/BF01649502.
Colonic perforation is the second most common complication of colonic neoplasms and is associated with an elevated morbidity and mortality. We undertook a two-centre retrospective analysis of 378 colonic neoplasms seen from 1978 to 1985. Thirty-six patients (9.5%) presented with a perforated colonic carcinoma. Two-thirds had a past history suggesting colonic disease while in the remaining one-third, the perforation was the first manifestation of the disease. Resection was carried out initially in 33 cases (21 Hartmann's procedure, 9 primary anastomosis, 2 mucous fistula and 1 abdominoperineal excision). Two patients had a proximal colostomy only and 1 an exploratory laparotomy only because of disseminated disease. Postoperative mortality was 14% (five cases). Actuarial survival rate was 52% at 1 year and 40% at 2 years. Eleven patients are still alive after a mean follow-up of 43 months.
结肠穿孔是结肠肿瘤的第二常见并发症，与发病率和死亡率升高相关。我们对1978年至1985年间所见的378例结肠肿瘤进行了一项双中心回顾性分析。36例患者（9.5%）表现为结肠癌穿孔。三分之二的患者有提示结肠疾病的既往史，而其余三分之一患者中，穿孔是疾病的首发表现。最初33例患者接受了手术切除（21例行哈特曼手术，9例行一期吻合术，2例行黏液瘘手术，1例行腹会阴联合切除术）。2例患者仅行近端结肠造口术，1例患者因疾病播散仅行剖腹探查术。术后死亡率为14%（5例）。精算生存率在1年时为52%，2年时为40%。平均随访43个月后，11例患者仍存活。
