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目的总结左侧结肠癌并急性肠梗阻I期切除吻合术的体会。方法对28例全身情况及局部肠管条件均较好的左侧结肠癌并急性肠梗阻患者,术中用碘伏生理盐水和甲硝唑液彻底对梗阻近端结肠进行密闭式灌洗,根治切除后用吻合器行近、远端结肠Ⅰ期吻合术,并在末段回肠置减压管。结果 28例患者例均顺利完成手术。术后7~9 d拔去吻合口附近腹腔引流管。14 d拔去末段回肠置减压管。本组未发生吻合口瘘及死亡病例。结论对左侧结肠癌合并急性肠梗阻的患者,只要严格掌握手术适应证和手术方式,术中采取密闭式梗阻近端结肠灌洗和末段回肠置管减压,可有效预防吻合口瘘的发生。
Objective To summarize the experience of stage I resection and anastomosis of left colon cancer and acute intestinal obstruction. Methods Twenty-eight patients with left colon cancer and acute intestinal obstruction who had better systemic conditions and local bowel conditions were treated with iodophor and metronidazole solution. The proximal colon obstruction was completely irrigated and the excision was performed After using stapler line near, distal colon â ... ¢ anastomosis, and in the final ileum placed decompression tube. Results 28 cases of patients were successfully completed the operation. After 7 ~ 9 d pull the abdominal drainage tube near the anastomosis. 14 d pull the final ileum decompression tube. This group did not occur anastomotic leakage and deaths. Conclusions For patients with left colon cancer complicated with acute intestinal obstruction, as long as strict indications of surgical indications and surgical methods, intraoperative closed obstruction proximal colonic lavage and distal ileal catheter decompression, which can effectively prevent anastomotic leakage occur.