摘要:目的：回顾性分析比较左半结肠癌急性梗阻一期手术与同期左半结肠癌根治术患者的手术临床资料,探讨左半结肠癌急性梗阻一期手术的可行性。方法： 回顾性将我中心2004年1月至2007年3月收治的59例左半结肠癌急性梗阻一期手术病例分为A组,将同期226例左半结肠癌根治术病例分为B组,比较两组之间清除淋巴结数、术后进食时间、吻合口漏发生率、肺部感染率、切口感染率、住院时间、复发和转移率。结果： 在上述观察指标中,在A组分别为（133±18）枚,（36±09）d,1/59（169%）,4/59（678%）,2/59（339%）,(124±09)d,6/59（1017%）；B组分别为128±15,32±08,1/226（044%）,8/226（354%）,6/226（265%）,117±15,23/226（1062%）；经统计学处理,两组间没有显著性差异。结论：术中合理应用结肠灌洗,良好的手术技巧,术后积极辅助治疗,左半结肠癌急性梗阻一期手术是安全可行的,可避免二次手术带给患者的痛苦,术后并发症也无明显增加。Abstract: Objective: Retrospective analysis and comparison of acute obstruction of left colon cancer onestage surgery and the same period a radical mastectomy in patients with left colon cancer surgery clinical data,To study the possibility of acute obstruction of left colon cancer onestage surgery. Methods:A retrospective of my center from January 2004 to March 2007 were treated 59 cases of acute obstruction of left colon cancer onestage surgery patients were divided into A group, will be left over the same period 226 cases of radical resection of colon cancer patients were divided into group B, compare the number of lymph nodes removed between the two groups, after the consumption of time, the incidence of anastomotic leakage, pulmonary infection, incision infection, length of stay, recurrence and metastasis rate. Results: Observed in the above indicators, in the A group were 133±18,36±09,1/59 (169%),4/59 (678%), 2/59 (339%),124±09,6/59 (1017%); B group were 128±15,32±08,1/226 (044%), 8/226 (354%), 6/226 (265%), 117±15,23/226 (1062%); Statistical analysis between the two groups there was no significant difference. Conclusion: Rational application of intraoperative colonic irrigation, good surgical technique, postoperative adjuvant treatment of active, acute obstruction of left colon cancer onestage surgery is a safe and feasible, it may avoid the second operation to bring the patient’s pain, postoperative complications and no increased significantly.
ObjectiveTo investigate the influence of surgical treatment on early postoperative anal function in left colon cancer patients with acute complete obstruction. MethodsThe clinical data of left colon cancer patients with acute complete obstruction were retrospectively chosen from January 2017 to June 2020 in Yibin Second People’s Hospital. The patients were grouped according to the treatment plan including emergency operation group (54 cases), stent+operation group (46 cases) and stent+neoadjuvant chemotherapy (NAC)+operation group (44 cases). The anal function was evaluated at 4 weeks, 1 month and 6 months after operation, and quality of life was evaluated at 12 months after operation. Unconditional logistic regression model was used to explore the factors influencing early postoperative anal function injury. Results The proportion of open surgery in the emergency operation group was statistically higher than the stent+operation group and stent+NAC+operation group (P<0.05). The low anterior rectum resection syndrome (LARS) score at 4 weeks after operation of the emergency operation group was statistically higher than those of the stent+operation group and stent+NAC+operation group (P<0.05). However there was no statistical difference in LARS score at 1 month and 6 months after operation among the three groups (P>0.05). The score of social function in the emergency operation group at 12 months after operation was statistically lower than those of the stent+operation group and stent+NAC+operation group (P<0.05). Multivariate logistic regression analysis showed that body mass index (BMI) ≥24 kg/m2, emergency operation, and Eastern Collaborative Oncology Group (ECOG) score were the risk factors for early postoperative anal dysfunction in the left colon cancer patients with acute complete obstruction (P<0.05). ConclusionsLeft colon cancer patients complicated with acute complete obstruction who only received emergency surgery, BMI≥24 kg/m2, or one score of ECOG are more likely to have functional impairment, and the quality of life of those patients underwent emergency surgery alone is decreased. In addition, the stent placement at the obstruction site should be helpful to avoid the above problems.