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上海市卫生健康委员会
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高龄结肠癌并发急性肠梗阻的外科治疗体会（附39例报告）
The surgical treatment of colon carcinoma complicated with acute intestinal obstruction in advanced age patients: a report of 39 cases

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DOI:
作者:
庄彪，倪熊，瞿惠龙，邹奇，陈杰
Zhuang Biao, Ni Xiong, Qu Hui-long, Zou Qi, Chen J
作者单位:
上海市浦东新区南汇中心医院胃肠外科
Department of Gastroenterological Surgery, Nan Hui Central Hospital of Pudong New District, Shang Hai, 201399, China
关键词:
结肠癌；肠梗阻；高龄；手术
colon carcinoma; intestinal obstruction; advanced age patients; surgical treatment
摘要:
【摘要】 目的 探讨高龄结肠癌并急性肠梗阻的外科治疗方法。方法 回顾性分析我院2009年1月～2012年7月，年龄≥70岁的39例结肠癌并急性肠梗阻病例的临床资料。结果 全组病例均行手术治疗，I期切除35例（89.7%），其中I期吻合20例（51.3%），发生吻合口瘘2例(5.1%)；单纯造口4例（10.3%）。全组死亡2例（5.1%）。结论 只要结合高龄结肠癌并急性肠梗阻的术前误诊率高、晚期病例多、并存病及术后并发症多等特点，严格掌握手术适应证，高度重视围手术期处理，大多数病例可以选择I期手术，切除原发肿瘤，对改善患者预后和提高生命质量具有极为重要的临床意义。
【Abstract】Objective To investigate the surgical effects of colon carcinoma complicated with acute intestinal obstruction in advanced age patients. Methods Clinical data of 39 patients aged 70 years or elder with colon carcinoma and acute intestinal obstruction who were diagnosed and treated from January 2009 to July 2012 were studied retrospectively. Results Every one of 39 patients underwent operation. 35 cases(89.7%) received primary hemicolectomy, which contained 20 cases(51.3%) accepted one-stage resection and anastomosis, anastomotic leakage occurred in 2 patients(5.1%); 4 cases(10.3%) underwent palliative colostomy. 2 cases(5.1%) were dead in all the patients. Conclusion There are higher rate of misdiagnosis, more comorbidities and postoperative complications in advanced age patients with colon carcinoma and acute intestinal obstruction. It is safe for the majority of these patients to undergo one-stage resection and anastomosis. But indications and perioperative period managements should be emphasized. These are important for better prognosis and quality of life.

 

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