摘要
目的探讨肠腔内外双套管负压引流在左半结肠癌并急性梗阻一期切除吻合中的可行性与安全性。方法前瞻性收集2009年1月至2012年12月期间笔者所在医院收治的81例左半结肠癌并急性梗阻患者,随机分为一期组（n=41）和对照组（n=40）。一期组在肠腔内外双套管负压引流、全结肠灌洗及小肠减压的条件下行急诊一期切除吻合,对照组行传统分期手术,比较2组患者的手术时间、术中出血量、术后排气时间,住院时间、住院费用及吻合口漏等手术并发症的差异。结果一期组和对照组患者的手术时间〔（166±19）min比（173±23）min〕、术中出血量〔（253±42）m L比（273±50）m L〕及术后排气时间〔（3.24±0.73）d比（3.50±0.95）d〕比较差异均无统计学意义（P〉0.05）,但一期组的住院时间〔（15.1±2.3）d比（23.1±4.1）d〕和住院费用〔（3.70±0.68）万元比（5.77±0.95）万元〕均短于（少于）对照组（P〈0.05）。在并发症方面,一期组和对照组患者的伤口感染〔7.3%（3/41）比10.0%（4/40）〕、盆腹腔感染〔4.9%（2/41）比10.0%（4/10）〕、肺部感染〔12.2%（5/41）比15.0%（6/40）〕及吻合口漏〔2.4%（1/41）比5.0%（2/40）〕发生率比较差异均无统计学意义（P〉0.05）。术后所有患者均获访,随访时间为1~36个月,中位数为22个月。随访期间,2组患者的死亡率〔0（0/41）比2.5%（1/40）〕、复发率〔2.4%（1/41）比5.0%（2/40）〕及转移率〔7.3%（3/41）比10.0%（4/40）〕比较差异均无统计学意义（P〉0.05）。结论在肠腔内外双套管负压引流、全结肠灌洗及小肠减压的条件下,左半结肠癌并急性梗阻行一期切除吻合是安全和可行的。
Objective To investigate the feasibility and safety of the double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis of left colon cancer combined with acute obstruction. Methods Eighty-one cases of left colon cancer combined with acute obstruction who underwent surgeries in our hospital from January 2009 to December 2012 were collected prospectively, and were divided into one-stage surgery group（n=41） and control group（n=40）. Cases of one-stage surgery group received double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis, and cases of control group underwent two-stage surgeries. Comparison of operation time, blood loss, time of anal exhaust after operation, hospital stay, hospital expense, and incidence of complication between the 2 groups was performed. Results There were no significant difference in the operation time 〔（166±19） minutes vs.（173±23） minutes〕, blood loss 〔（253±42） m L vs.（273±50） m L〕, and time of anal exhaust after operation 〔（3.24±0.73） days vs.（3.50±0.95） days〕 beeween one-stage surgery group and control group, but hospital stay 〔（15.1±2.3） days vs.（23.1±4.1） days〕 and hospital expense 〔（3.70±0.68） ×105yuan vs.（5.77±0.95） ×105 yuan〕of one-stage surgery group were lower than those of control group（P〈0.05）. In addition, there were no significant difference in the incidences of wound infection 〔7.3%（3/41） vs. 10.0%（4/40）〕, intraabdominal infection 〔4.9%（2/41） vs. 10.0%（4/10）〕, pulmonary infection 〔12.2%（5/41） vs. 15.0%（6/40）〕, and anastomotic leakage〔2.4%（1/41） vs. 5.0%（2/40）〕 beeween one-stage surgery group and control group（P〉0.05）. All of the cases were followed up for 1-36 months, and the median time were 22 months. There were no significant difference in the mortality 〔0（0/41）vs. 2.5%（1/40）〕, recurrenc
出处
《中国普外基础与临床杂志》
CAS
2015年第3期307-311,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
左半结肠癌
急性梗阻
双套管引流
效果
Left colon cancer
Acute obstruction
Double cavity casing negative pressure drainage
Effect
