左半结肠癌合并肠梗阻置入金属内支架后ⅰ期切除吻合术的疗效分析

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1、左半结肠癌合并肠梗阻置入金属内支架后I期切除吻合术的疗效分析［摘要］目的探讨左半结肠癌合并肠梗阻置入金属内支架后I期切除吻合术的可行性和疗效。方法选取2011年1月〜2013年12月本院收治的24例左半结肠癌合并肠梗阻置入金属内支架后行I期切除吻合术患者作为观察组，选取左半结肠癌合并肠梗阻行分期手术的29例患者作为第1对照组，选取左半结肠癌未合并肠梗阻行左半结肠癌根治术的32例患者作为第2对照组。比较三组的手术时间、术中出血量、淋巴结的清除数量、术后住院时间、术后排气时间、腹腔引流天数、吻合口痿发生率、切口感染率、肺部感染率等。结果观察组的手术时间显著短于第1对照组

2、，术中出血量显著少于第1对照组，术后切口感染率显著低于第1对照组，差异有统计学意义(P0.05)o结论金属支架置入后I期切除吻合术治疗结肠癌合并肠梗阻安全可行，不增加术后吻合口痿，可避免二次手术痛苦，具有住院时间短、医疗费用少、术后并发症少等优点。［关键词］左半结肠癌；肠梗阻；支架；I期切除吻合术［中图分类号］R735.3+5［文献标识码］A［文章编号］1674-4721(2016)03(b)-0071-04［Abstract］ObjectiveToexplorethefeasibilityandeffectofcuttingoffanastomosisinonep

3、haseofmetalstentaftermergerinlefthalfcoloncancerandintestinalobstruction.Methods24patientswithlefthalfcoloncancerandintestinalobstructionconductedcuttingoffanastomosisinonephaseofmetalstentaftermergerfromJanuary2011toDecember2013inourhospitalwereselectedastheobservationgroup,29patients

4、withlefthalfcoloncancerandintestinalobstructionconductedphasedoperationwereselectedasthefirstcontrolgroup,32patientswithlefthalfcoloncancerunincorportedintestinalobstructionconductedlefthalfcoloncancerradicalresectionwereselectedasthesecondcontrolgroup.Theoperationtime,bleedingduringop

5、eration,clearamountoflymphnode,hospitalstayafteroperation,postoperativeexhausttime,abdominalcavitydrainagedays,incidencerateofanastomoticleakage,incisioninfectionrateandlunginfectionrateamongthreegroupswascomparedrespectively.ResultsTheoperationtimeoftheobservationgroupwasshorterthanth

6、atofthefirstcontrolgroup,theamountofbleedingintheobservationgroupwaslessthaninthefirstcontrolgroup,postoperativeincisioninfectionrateintheobservationgroupwaslowerthanthatinthefirstcontrolgroup,withsignificantdifference(P0.05).ConclusionItisfeasibilityandsafetyofcuttingoffanastomosisino

7、nephaseofmetalstentaftermergerinthetreatmentoflefthalfcoloncancerandintestinalobstruction,whichcannotincreasepostoperativeanastomoticleakage,avoidthepainofsecondaryoperationandwithadvantagesofshorthospitalstay,lesshospitalizationcostsandlesspostoperativecomplication.梗阻性结直肠癌患者的一般全身情况差