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目的探讨急诊一期根治性切除吻合手术治疗结直肠癌合并肠梗阻的效果。方法回顾性分析1997年2月—2009年2月急诊一期根治性切除吻合手术治疗结直肠癌合并肠梗阻112例的临床资料。结果 112例中采用右侧腹直肌切口44例,术后切口感染2例,切口感染并吻合口瘘6例;采用左侧腹直肌切口68例,术后切口感染并吻合口瘘1例。左侧腹直肌切口术后切口感染及吻合口瘘明显少于右侧腹直肌切口(P<0.05)。均康复出院,无手术死亡。结论术前尽可能地明确梗阻原因、梗阻部位,采用左侧腹直肌手术切口是结直肠癌合并肠梗阻一期根治性切除吻合手术成功的重要因素。
Objective To investigate the effect of radical resection and anastomosis in the treatment of colorectal cancer with intestinal obstruction. Methods The clinical data of 112 patients with colorectal cancer with intestinal obstruction undergoing radical resection and anastomosis from January 1997 to February 2009 were retrospectively analyzed. Results In the 112 cases, 44 cases were performed incision on the right rectus abdominis, 2 cases were incision infection, 6 cases were incision infection and anastomotic fistula. Sixty-eight cases of incision on the left rectus abdominis were performed. One case of postoperative wound infection and anastomotic leakage . The incision infection and anastomotic fistula in the left rectus abdominis incision were significantly less than those in the right rectus abdominis incision (P <0.05). All recovered and discharged without surgery. Conclusions The reason of obstruction should be clarified as much as possible before operation. The operation of the left rectus abdominis muscle incision is an important factor in the success of radical resection and anastomosis in colorectal cancer with intestinal obstruction.